DWB Human Services Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

071-006419 Issued in IL

Legal business name

DWB HUMAN SERVICES INC

Practice address

4350 N Hermitage Ave
Chicago, IL 60613-1106

Phone

(773) 327-9356

Fax

(773) 348-8220

NPI assigned

Mar 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dianna Bolen, PSYDNPI 1417089293

Title

Owner

Phone

(773) 327-9356

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dianna W Bolen, PSYD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1417089293
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1891827655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 N HERMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131106",
            "telephone_number": "773-327-9356",
            "fax_number": "773-348-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N HERMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131106",
            "telephone_number": "773-327-9356",
            "fax_number": "773-348-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWB HUMAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "BOLEN",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-327-9356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "071-006419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01632869",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margot Beth Duxler, PH.D
• Bethany Soule Duyser, RN, APN
• Shahd Duzdar, MD
• DV Management Services Group,Inc.
• Jerry Dvoracek, D.D.S
• Philip Dwek, M.D.
• Anjana Dwivedi, ANJANA DWIVEDI, M.D.
• Lisa N Dworkin-Cantor
• Anna Dworkin
• DWP Counseling and Wellness LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.