Provider Demographics
NPI:1669950911
Name:CHICAGO PERSONAL GROWTH INSTITUTE
Entity type:Organization
Organization Name:CHICAGO PERSONAL GROWTH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:J
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-636-7516
Mailing Address - Street 1:223 W JACKSON BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-6915
Mailing Address - Country:US
Mailing Address - Phone:312-781-9550
Mailing Address - Fax:312-631-3155
Practice Address - Street 1:223 W JACKSON BLVD STE 360
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-6915
Practice Address - Country:US
Practice Address - Phone:312-781-9550
Practice Address - Fax:312-631-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty