SYDNEYMALCOME LLC


Address: 307 N Michigan Ave Ste 410, Chicago, IL 60601-5318
Phone: 3128841893

SYDNEYMALCOME LLC (NPI# 1881193464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881193464
Entity Type Organization
Organization Name SYDNEYMALCOME LLC
Practice Address 307 N Michigan Ave Ste 410
Chicago
IL 60601-5318
Mailing Address 1420 S Michigan Ave
Chicago
IL 60605-2811
Practice Telephone 3128841893
Enumeration Date 2018-02-08
Last Update Date 2018-02-08
Authorized Official Name MS. MARION MALCOME (OWNER)
Authorized Official Telephone 3128841893
Authorized Official Credential LCSW
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
149.013372 IL Ambulatory Health Care Facilities

Office Location

Street Address 307 N MICHIGAN AVE STE 410
City CHICAGO
State IL
Zip Code 60601-5318

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1427574714 Nicole Woodcox Bolden Social Worker 205 N Michigan Ave Ste 1660, Chicago, IL 60601 2017-08-17
1912431560 Shannon Keleher Social Worker 155 N Michigan Ave Ste 209, Chicago, IL 60601 2017-04-19
1659828630 Kevin Mcguyer Physical Therapist 151 N Michgan Ave, Chicago, IL 60601 2016-09-07
1598116618 Charles Raymond Culpepper Counselor 155 N Michigan Ave Ste 608, Chicago, IL 60601 2016-06-30
1629494042 Farah Huq Counselor 180 N Michigan Ave, Ste 410, Chicago, IL 60601 2014-03-10
1609147628 Kathleen M Walsh Social Worker 155 N Michigan Av, #523, Chicago, IL 60601 2012-01-23
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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