Provider Demographics
NPI:1902955164
Name:ASSOCIATE'S FOR LIFE'S CHALLENGES
Entity Type:Organization
Organization Name:ASSOCIATE'S FOR LIFE'S CHALLENGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSY. D.
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-455-8904
Mailing Address - Street 1:900 W JACKSON BLVD
Mailing Address - Street 2:SUITE 7 WEST
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3024
Mailing Address - Country:US
Mailing Address - Phone:312-455-8904
Mailing Address - Fax:
Practice Address - Street 1:900 W JACKSON BLVD
Practice Address - Street 2:SUITE 7 WEST
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3024
Practice Address - Country:US
Practice Address - Phone:312-455-8904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty