Provider Demographics
NPI:1861146284
Name:MUGEN PSYCHIATRY LLC
Entity type:Organization
Organization Name:MUGEN PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-427-9243
Mailing Address - Street 1:3023 N CLARK ST STE 593
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5200
Mailing Address - Country:US
Mailing Address - Phone:205-427-9243
Mailing Address - Fax:314-405-9688
Practice Address - Street 1:3023 N CLARK ST STE 593
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5200
Practice Address - Country:US
Practice Address - Phone:205-427-9243
Practice Address - Fax:314-405-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty