OrganizationActive
Blue Willow Therapy, LLC
NPI 1417629353 · Adult Mental Health Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1417629353
- Entity type
- Organization
- Primary specialty
- Adult Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Taneka Taylor, Clinical Therapist(217) 691-2760
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2343 W Winona St
Chicago, IL 60625-1853
Phone: (217) 691-2760
Approximate (ZIP-level) locationGet directions
Mailing address
2343 W Winona St Apt 2e
Chicago, IL 60625-1853
Registry dates
- Enumerated
- 2021-09-29
- Last updated
- 2021-12-20
- Certified
- 2021-12-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.