Provider Demographics
NPI:1245831569
Name:CHICAGO PSYCHIATRIC LLC
Entity type:Organization
Organization Name:CHICAGO PSYCHIATRIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KATHOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-612-9667
Mailing Address - Street 1:2001 N HALSTED ST STE 304
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4365
Mailing Address - Country:US
Mailing Address - Phone:312-612-9667
Mailing Address - Fax:312-872-7660
Practice Address - Street 1:2001 N HALSTED ST STE 304
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4365
Practice Address - Country:US
Practice Address - Phone:312-612-9667
Practice Address - Fax:312-872-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health