Provider Demographics
NPI:1215661095
Name:HUSBANDS, ETHAN
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:HUSBANDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S MICHIGAN AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3307
Mailing Address - Country:US
Mailing Address - Phone:312-609-5300
Mailing Address - Fax:
Practice Address - Street 1:8 S MICHIGAN AVE STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3307
Practice Address - Country:US
Practice Address - Phone:312-609-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health