MEDICARE: CHRISTOPHER WEST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1144519323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER WEST

Provider Business Mailing Address
First Line	:	651 E 50TH PL
Second Line	:	APT 1W
City	:	CHICAGO
State	:	IL
Zip	:	60615-2519
Country	:	US
Telephone Number	:	909-556-5807
Fax Number	:

Provider Business Practice Location Address
First Line	:	651 E 50TH PL
Second Line	:	APT 1W
City	:	CHICAGO
State	:	IL
Zip	:	60615-2519
Country	:	US
Telephone Number	:	909-556-5807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	03/28/2011

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Directions to “ CHRISTOPHER WEST ” Practice Location

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