Provider Demographics
NPI:1861550733
Name:DUKANE MENTAL HEALTH CLINICS, LTD.
Entity type:Organization
Organization Name:DUKANE MENTAL HEALTH CLINICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHIAPPETTA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-695-7512
Mailing Address - Street 1:1970 LARKIN AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5891
Mailing Address - Country:US
Mailing Address - Phone:847-695-7512
Mailing Address - Fax:847-695-1009
Practice Address - Street 1:1970 LARKIN AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5891
Practice Address - Country:US
Practice Address - Phone:847-695-7512
Practice Address - Fax:847-695-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71749103TC0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty