Provider Demographics
NPI:1497933881
Name:ESTABLISHING, MANAGING AND GENERATING EFFECTIVE SERVICES
Entity Type:Organization
Organization Name:ESTABLISHING, MANAGING AND GENERATING EFFECTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WASH
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:312-613-2846
Mailing Address - Street 1:110 E. 79TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-2302
Mailing Address - Country:US
Mailing Address - Phone:773-224-7685
Mailing Address - Fax:
Practice Address - Street 1:110 E. 79TH STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-2302
Practice Address - Country:US
Practice Address - Phone:773-224-7683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-5889-0001-A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health