Provider Demographics
NPI:1104464916
Name:MAINSAIL THERAPEUTICS LLC
Entity type:Organization
Organization Name:MAINSAIL THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-246-0714
Mailing Address - Street 1:333 N OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2120
Mailing Address - Country:US
Mailing Address - Phone:217-246-0714
Mailing Address - Fax:
Practice Address - Street 1:2551 N CLARK ST STE 800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4984
Practice Address - Country:US
Practice Address - Phone:312-257-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty