Provider Demographics
NPI:1134667868
Name:CHICAGO THERAPY CENTERS
Entity Type:Organization
Organization Name:CHICAGO THERAPY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:708-724-5668
Mailing Address - Street 1:2451 N LINCOLN AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1509
Mailing Address - Country:US
Mailing Address - Phone:708-724-5668
Mailing Address - Fax:773-661-2640
Practice Address - Street 1:2451 N LINCOLN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1509
Practice Address - Country:US
Practice Address - Phone:708-724-5668
Practice Address - Fax:773-661-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health