Provider Demographics
NPI:1902383953
Name:HEALING EMPOWERING & LEARNING PROFESSIONALS LLC
Entity Type:Organization
Organization Name:HEALING EMPOWERING & LEARNING PROFESSIONALS LLC
Other - Org Name:HELP LLC CHICAGO CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCURTIS WITHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-819-5504
Mailing Address - Street 1:2930 S MICHIGAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3484
Mailing Address - Country:US
Mailing Address - Phone:773-819-5504
Mailing Address - Fax:
Practice Address - Street 1:2930 S MICHIGAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:773-819-5504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING EMPOWERING & LEARNING PROFESSIONALS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17013261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7108608Medicaid