Provider Demographics
NPI:1467461285
Name:BEHAVIORAL HEALTH, S.C.
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-329-1390
Mailing Address - Street 1:9150 CRAWFORD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1700
Mailing Address - Country:US
Mailing Address - Phone:847-329-1390
Mailing Address - Fax:847-677-7760
Practice Address - Street 1:9150 CRAWFORD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1700
Practice Address - Country:US
Practice Address - Phone:847-329-1390
Practice Address - Fax:847-677-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty