Provider Demographics
NPI:1144905654
Name:GRADATIONS STUDIO P.C.
Entity type:Organization
Organization Name:GRADATIONS STUDIO P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARISIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ATR-BC
Authorized Official - Phone:773-965-8026
Mailing Address - Street 1:2530 N RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2620
Mailing Address - Country:US
Mailing Address - Phone:773-965-8026
Mailing Address - Fax:
Practice Address - Street 1:3057 N ROCKWELL ST STE 238
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7917
Practice Address - Country:US
Practice Address - Phone:773-831-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)