Provider Demographics
NPI:1881392678
Name:ILLINOIS BEHAVIORAL HEALTH GROUP, P.C.
Entity type:Organization
Organization Name:ILLINOIS BEHAVIORAL HEALTH GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-329-9210
Mailing Address - Street 1:5550 TOUHY AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3253
Mailing Address - Country:US
Mailing Address - Phone:847-329-9210
Mailing Address - Fax:773-347-2656
Practice Address - Street 1:5550 TOUHY AVE STE 404
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3253
Practice Address - Country:US
Practice Address - Phone:847-329-9210
Practice Address - Fax:773-347-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty