Provider Demographics
NPI:1285879668
Name:A&K CHILD GUIDANCE CENTER INC.
Entity type:Organization
Organization Name:A&K CHILD GUIDANCE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHARE HOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:630-337-2893
Mailing Address - Street 1:641 S LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3451
Mailing Address - Country:US
Mailing Address - Phone:630-337-2893
Mailing Address - Fax:
Practice Address - Street 1:641 S LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3451
Practice Address - Country:US
Practice Address - Phone:630-337-2893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119188251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health