Provider Demographics
NPI:1124357421
Name:CAFAL CLINIC FOR PSYCHOATRIC AND CONSULTATION SERVICES SC
Entity Type:Organization
Organization Name:CAFAL CLINIC FOR PSYCHOATRIC AND CONSULTATION SERVICES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND SOLE SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:MEHJABEEN
Authorized Official - Last Name:HADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-715-8146
Mailing Address - Street 1:455 DUNHAM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1453
Mailing Address - Country:US
Mailing Address - Phone:630-770-3475
Mailing Address - Fax:331-901-5127
Practice Address - Street 1:455 DUNHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1453
Practice Address - Country:US
Practice Address - Phone:630-770-3475
Practice Address - Fax:331-901-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005355101YP2500X
261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty