Provider Demographics
NPI:1710518865
Name:HONESTLY OLIVE HOLISTIC MENTAL HEALTHCARE
Entity Type:Organization
Organization Name:HONESTLY OLIVE HOLISTIC MENTAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEV
Authorized Official - Middle Name:G
Authorized Official - Last Name:ILDIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-292-9739
Mailing Address - Street 1:1 E ERIE ST STE 525-5175
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2740
Mailing Address - Country:US
Mailing Address - Phone:312-292-9739
Mailing Address - Fax:
Practice Address - Street 1:1 E ERIE ST STE 525-5175
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2740
Practice Address - Country:US
Practice Address - Phone:312-292-9739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1003240516OtherLICENSED PSYCHOLOGIST
IL1164062782OtherLICENSED PSYCHOLOGIST