| Mfbstudio Inc | |
|
475 W 55th St Ste 108 Countryside IL 60525-3565 | |
| (708) 688-9171 | |
| Not Available |
| Full Name | Mfbstudio Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 475 W 55th St Ste 108, Countryside, Illinois |
| Authorized Official Name and Position | Mary France Bazan (OWNER/ LCPC PROVIDER) |
| Authorized Official Contact | 7086889171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mfbstudio Inc 6055 W 64th St Chicago IL 60638-5307 Ph: (773) 710-4428 | Mfbstudio Inc 475 W 55th St Ste 108 Countryside IL 60525-3565 Ph: (708) 688-9171 |
| NPI Number | 1205647419 |
|---|---|
| Provider Enumeration Date | 01/16/2025 |
| Last Update Date | 01/16/2025 |
| Certification Date | 01/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205647419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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