Provider Demographics
NPI:1669821542
Name:RELATIONSHIP REALITY 312, INC.
Entity Type:Organization
Organization Name:RELATIONSHIP REALITY 312, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHLIPALA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:312-399-1635
Mailing Address - Street 1:70 E LAKE ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 E LAKE ST
Practice Address - Street 2:SUITE 222
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5959
Practice Address - Country:US
Practice Address - Phone:312-399-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000833106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty