Basic Information
Provider Information
NPI: 1265166029
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CATCHINGS
FirstName: NATHANIEL
MiddleName:  
NamePrefix:  
NameSuffix: II
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1925 SOUTH OAK PARK APT 2
Address2:  
City: BERWYN
State: IL
PostalCode: 60402
CountryCode: US
TelephoneNumber: 3124801516
FaxNumber:  
Practice Location
Address1: 1414 MAIN ST
Address2:  
City: MELROSE PARK
State: IL
PostalCode: 601603902
CountryCode: US
TelephoneNumber: 7086810073
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/15/2022
LastUpdateDate: 07/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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