Provider Demographics
NPI:1700590346
Name:ESTABLISHING, MANAGING & GENERATING EFFECTIVE SERVICES INC
Entity type:Organization
Organization Name:ESTABLISHING, MANAGING & GENERATING EFFECTIVE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WASH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-613-2846
Mailing Address - Street 1:7601 S KOSTNER AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1100
Mailing Address - Country:US
Mailing Address - Phone:312-613-2846
Mailing Address - Fax:773-224-7685
Practice Address - Street 1:7601 S KOSTNER AVE STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1100
Practice Address - Country:US
Practice Address - Phone:312-613-2846
Practice Address - Fax:773-224-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILBHC99999Medicaid