Provider Demographics
NPI:1467852483
Name:CHICAGO COUNSELING & TRAINING, INC
Entity Type:Organization
Organization Name:CHICAGO COUNSELING & TRAINING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOYAM
Authorized Official - Middle Name:HUSSIEN
Authorized Official - Last Name:TANON
Authorized Official - Suffix:
Authorized Official - Credentials:MACC, QMQP
Authorized Official - Phone:773-673-3702
Mailing Address - Street 1:4817 W. 83RD STREET
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459
Mailing Address - Country:US
Mailing Address - Phone:773-673-3702
Mailing Address - Fax:
Practice Address - Street 1:4817 W. 83RD STREET
Practice Address - Street 2:BURBANK MEDICAL CENTER
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459
Practice Address - Country:US
Practice Address - Phone:773-673-3702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty