Provider Demographics
NPI:1265665673
Name:SPIRIT HEALTHCARE, INC
Entity Type:Organization
Organization Name:SPIRIT HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-568-0972
Mailing Address - Street 1:3515 W HOWARD ST
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-4001
Mailing Address - Country:US
Mailing Address - Phone:847-564-0972
Mailing Address - Fax:847-568-0975
Practice Address - Street 1:3515 W HOWARD ST
Practice Address - Street 2:SUITE 1007
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-4001
Practice Address - Country:US
Practice Address - Phone:847-564-0972
Practice Address - Fax:847-568-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty