Provider Demographics
NPI:1548534829
Name:WHOLE FAMILY, INC
Entity type:Organization
Organization Name:WHOLE FAMILY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-519-3187
Mailing Address - Street 1:1655 W SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1043
Mailing Address - Country:US
Mailing Address - Phone:312-519-3187
Mailing Address - Fax:773-880-1315
Practice Address - Street 1:1655 W SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1043
Practice Address - Country:US
Practice Address - Phone:312-519-3187
Practice Address - Fax:773-880-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-03
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149012783261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health