Provider Demographics
NPI:1134512189
Name:CONTRERAS, EMANUEL H
Entity Type:Individual
Prefix:
First Name:EMANUEL
Middle Name:H
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3265 W ARMITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3759
Mailing Address - Country:US
Mailing Address - Phone:773-862-4675
Mailing Address - Fax:773-862-4685
Practice Address - Street 1:3265 W ARMITAGE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3759
Practice Address - Country:US
Practice Address - Phone:773-862-4675
Practice Address - Fax:773-862-4685
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health