Provider Demographics
NPI:1437667805
Name:PARTNERSHIPS IN BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:PARTNERSHIPS IN BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:312-730-3966
Mailing Address - Street 1:9933 S WESTERN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1810
Mailing Address - Country:US
Mailing Address - Phone:312-730-3966
Mailing Address - Fax:312-803-1635
Practice Address - Street 1:9933 S WESTERN AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1810
Practice Address - Country:US
Practice Address - Phone:312-730-3966
Practice Address - Fax:312-803-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009102103TC0700X
IL1490085201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty