Provider Demographics
NPI:1629181243
Name:ASSOCIATES IN PSYCHIATRIC WELLNESS, LP
Entity Type:Organization
Organization Name:ASSOCIATES IN PSYCHIATRIC WELLNESS, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-217-9019
Mailing Address - Street 1:5251 GALITZ ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3669
Mailing Address - Country:US
Mailing Address - Phone:224-217-9019
Mailing Address - Fax:847-770-4484
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:224-217-9019
Practice Address - Fax:847-770-4484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2009-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty