Provider Demographics
NPI:1659974053
Name:EQUAL MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:EQUAL MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROMERO GADDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-558-8478
Mailing Address - Street 1:3306 N HALSTED ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2974
Mailing Address - Country:US
Mailing Address - Phone:773-558-8478
Mailing Address - Fax:
Practice Address - Street 1:3306 N HALSTED ST STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2974
Practice Address - Country:US
Practice Address - Phone:773-558-8478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty