Provider Demographics
NPI:1235783630
Name:CHARLENE SANUADE
Entity Type:Organization
Organization Name:CHARLENE SANUADE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANUADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-803-2308
Mailing Address - Street 1:2443 MILLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5243
Mailing Address - Country:US
Mailing Address - Phone:281-830-9171
Mailing Address - Fax:844-364-0157
Practice Address - Street 1:29 S WEBSTER ST STE 390A
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5356
Practice Address - Country:US
Practice Address - Phone:630-803-2308
Practice Address - Fax:844-364-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty