Provider Demographics
NPI:1316568579
Name:GUIDANCE TREATMENT LLC CENTER
Entity Type:Organization
Organization Name:GUIDANCE TREATMENT LLC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:SADEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-772-8876
Mailing Address - Street 1:2004 N PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-3767
Mailing Address - Country:US
Mailing Address - Phone:773-772-8876
Mailing Address - Fax:773-252-3091
Practice Address - Street 1:2004 N PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-3767
Practice Address - Country:US
Practice Address - Phone:773-772-8876
Practice Address - Fax:773-252-3091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty