Provider Demographics
NPI:1932565330
Name:CARE FAMILY CONSULTATION LLC
Entity Type:Organization
Organization Name:CARE FAMILY CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAIFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7738-187-6717
Mailing Address - Street 1:405 N. WABASH
Mailing Address - Street 2:SUITE 814
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 N. WABASH
Practice Address - Street 2:SUITE 814
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610
Practice Address - Country:US
Practice Address - Phone:773-818-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007434103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty