Provider Demographics
NPI:1467754911
Name:MD MEDICAL, LLC
Entity Type:Organization
Organization Name:MD MEDICAL, LLC
Other - Org Name:LUXURY PSYCHIATRY AND MEDICAL SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-888-2986
Mailing Address - Street 1:213 N MORGAN ST UNIT 1D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1721
Mailing Address - Country:US
Mailing Address - Phone:312-888-2986
Mailing Address - Fax:
Practice Address - Street 1:213 N MORGAN ST UNIT 1D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1721
Practice Address - Country:US
Practice Address - Phone:312-888-2986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361224592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1871648642OtherNPI INDIVIDUAL