| King Community Mental Health Center Corp | |
|
4455 S King Drive Suite 101 Chicago IL 60653-3310 | |
| (773) 536-2700 | |
| (773) 751-2250 |
| Full Name | King Community Mental Health Center Corp |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4455 S King Drive, Chicago, Illinois |
| Authorized Official Name and Position | Roueen Rafeyan (OWNER) |
| Authorized Official Contact | 7735362700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| King Community Mental Health Center Corp 4455 S King Drive Suite 101 Chicago IL 60653-3310 Ph: (773) 536-2700 | King Community Mental Health Center Corp 4455 S King Drive Suite 101 Chicago IL 60653-3310 Ph: (773) 536-2700 |
| NPI Number | 1003056557 |
|---|---|
| Provider Enumeration Date | 02/24/2009 |
| Last Update Date | 06/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003056557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 036089152 (Illinois) | Primary |
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