Provider Demographics
NPI:1366465718
Name:DR ALBEHEARY & ASSOCIATES SC
Entity Type:Organization
Organization Name:DR ALBEHEARY & ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GHADA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBEHEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-613-0161
Mailing Address - Street 1:980 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1083
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4501
Mailing Address - Country:US
Mailing Address - Phone:312-202-9601
Mailing Address - Fax:312-202-9607
Practice Address - Street 1:980 N MICHIGAN AVE STE 1083
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4521
Practice Address - Country:US
Practice Address - Phone:312-202-9601
Practice Address - Fax:312-202-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361023552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102355Medicaid
IL036102355Medicaid
ILI38238Medicare UPIN