Provider Demographics
NPI:1780936856
Name:CHICAGO NEUROBEHAVIOR SPECIALISTS
Entity type:Organization
Organization Name:CHICAGO NEUROBEHAVIOR SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-349-4420
Mailing Address - Street 1:15040 S RAVINIA AVE STE 49
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3173
Mailing Address - Country:US
Mailing Address - Phone:708-349-4420
Mailing Address - Fax:708-349-4421
Practice Address - Street 1:15040 S RAVINIA AVE STE 49
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3173
Practice Address - Country:US
Practice Address - Phone:708-349-4420
Practice Address - Fax:708-349-4421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty