Provider Demographics
NPI:1750702890
Name:INNER LIFE PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:INNER LIFE PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:MARIAN
Authorized Official - Last Name:NAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-417-6462
Mailing Address - Street 1:1030 N CLARK ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-5467
Mailing Address - Country:US
Mailing Address - Phone:312-265-0288
Mailing Address - Fax:312-265-0346
Practice Address - Street 1:1030 N CLARK ST
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-5467
Practice Address - Country:US
Practice Address - Phone:312-265-0288
Practice Address - Fax:312-265-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
IL071008524103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty