Provider Demographics
NPI:1275072332
Name:WEST SUBURBAN BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:WEST SUBURBAN BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-726-7000
Mailing Address - Street 1:4580 WEAVER PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3865
Mailing Address - Country:US
Mailing Address - Phone:630-473-3970
Mailing Address - Fax:
Practice Address - Street 1:4580 WEAVER PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3865
Practice Address - Country:US
Practice Address - Phone:630-473-3970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009476103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty