Provider Demographics
NPI:1700662764
Name:INSTITUTE FOR THE HEALING ARTS LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR THE HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOSHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-719-9027
Mailing Address - Street 1:11120 LAUREL HILL DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8728
Mailing Address - Country:US
Mailing Address - Phone:312-719-9027
Mailing Address - Fax:
Practice Address - Street 1:920 N YORK RD STE 200
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8626
Practice Address - Country:US
Practice Address - Phone:312-719-9027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty