Provider Demographics
NPI:1790576544
Name:UNIVERSALL HEALING
Entity type:Organization
Organization Name:UNIVERSALL HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, R-DMT
Authorized Official - Phone:312-848-6582
Mailing Address - Street 1:1433 W SUMMERDALE AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2188
Mailing Address - Country:US
Mailing Address - Phone:312-848-6582
Mailing Address - Fax:
Practice Address - Street 1:1433 W SUMMERDALE AVE APT 2A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2188
Practice Address - Country:US
Practice Address - Phone:312-848-6582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health