| Far Northwest Psychiatric | |
|
6321 N Avondale Ave Suite A 101 Chicago IL 60631-1900 | |
| (773) 774-7555 | |
| (773) 774-8910 |
| Full Name | Far Northwest Psychiatric |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 6321 N Avondale Ave, Chicago, Illinois |
| Authorized Official Name and Position | Gerald Noonan (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8476354600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Far Northwest Psychiatric 1001 E Touhy Ave Suite 170 Des Plaines IL 60018-5801 Ph: (847) 635-4600 | Far Northwest Psychiatric 6321 N Avondale Ave Suite A 101 Chicago IL 60631-1900 Ph: (773) 774-7555 |
| NPI Number | 1720203326 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720203326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
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Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
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