MEDICARE: THE EVALUATION CENTER

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	036058176	IL
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center	36058176	IL
3	261QV0200X	VA Clinic/Center	36058176	IL

General Provider Information

NPI Number	:	1285027888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EVALUATION CENTER

Provider Business Mailing Address
First Line	:	3000 W LOGAN BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1708
Country	:	US
Telephone Number	:	312-944-1781
Fax Number	:	773-227-5940

Provider Business Practice Location Address
First Line	:	3000 W LOGAN BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1708
Country	:	US
Telephone Number	:	312-944-1781
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HELEN MORRISON
Credential	:	MD
Telephone Number	:	312-944-1781

Provider Enumeration Date	:	03/06/2015
Last Update Date	:	03/06/2015

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Directions to “THE EVALUATION CENTER ” Practice Location

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