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NPI Code Detail

MEDICARE: CLINICAL RESEARCH INSTITUTE, INC.

MEDICARE: CLINICAL RESEARCH INSTITUTE, INC.
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
1251V00000XVoluntary or Charitable Agency

General Provider Information

NPI Number : 1144663139
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICAL RESEARCH INSTITUTE, INC.
Provider Business Mailing Address
First Line : 5646 SAINT CHARLES RD
Second Line : SUITE C
City : BERKELEY
State : IL
Zip : 60163-1148
Country : US
Telephone Number : 630-544-7475
Fax Number :
Provider Business Practice Location Address
First Line : 5646 SAINT CHARLES RD
Second Line : SUITE C
City : BERKELEY
State : IL
Zip : 60163-1148
Country : US
Telephone Number : 630-544-7475
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. GARY R. JOHNSON
Credential : D.D.S.
Telephone Number : 630-544-7475
Provider Enumeration Date : 04/10/2013
Last Update Date : 10/26/2015

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Directions to “CLINICAL RESEARCH INSTITUTE, INC. ” Practice Location

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