Provider Demographics
NPI:1457704603
Name:WHOLEHEALTH THERAPY PARTNERS, INC
Entity Type:Organization
Organization Name:WHOLEHEALTH THERAPY PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:CZUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-209-5664
Mailing Address - Street 1:633 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:715 LAKE ST STE 410
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1413
Practice Address - Country:US
Practice Address - Phone:708-209-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.004472101YP2500X
IL071008544103TH0004X
IL056003247251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty