Provider Demographics
NPI:1619356649
Name:ENCOUNTER MEDICAL
Entity Type:Organization
Organization Name:ENCOUNTER MEDICAL
Other - Org Name:TWO DREAMS CHICAGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARTHWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FASAM
Authorized Official - Phone:708-613-4750
Mailing Address - Street 1:610 S MAPLE AVE
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1091
Mailing Address - Country:US
Mailing Address - Phone:708-613-4750
Mailing Address - Fax:708-613-4754
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 3400
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-613-4750
Practice Address - Fax:708-613-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder