| Creative Change | |
|
1480 Renaissance Dr Ste 212 Park Ridge IL 60068-1353 | |
| (847) 699-3399 | |
| (847) 299-3213 |
| Full Name | Creative Change |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1480 Renaissance Dr Ste 212, Park Ridge, Illinois |
| Authorized Official Name and Position | Amy L. Robinson (DIRECTOR) |
| Authorized Official Contact | 8476993399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Change 1480 Renaissance Dr Ste 212 Park Ridge IL 60068-1353 Ph: (847) 699-3399 | Creative Change 1480 Renaissance Dr Ste 212 Park Ridge IL 60068-1353 Ph: (847) 699-3399 |
| NPI Number | 1134236011 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134236011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Illinois) | Primary |
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