| NPI | 1811783079 |
|---|---|
| Doing Business As | PHOENIX CLINIC CHICAGO |
| Entity Type | Organization |
| Authorized Contact | TAYLOR ARIEL PETTWAY Executive Director 773-431-7397 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-12-16 |