Healthcare Provider Details

I. General information

NPI: 1629851324
Provider Name (Legal Business Name): JOHN MICHAEL CILEK TLMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E MARKET ST
IOWA CITY IA
52245-2628
US

IV. Provider business mailing address

1622 MUSCATINE AVE
IOWA CITY IA
52240-6233
US

V. Phone/Fax

Practice location:
  • Phone: 319-853-8899
  • Fax:
Mailing address:
  • Phone: 319-936-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: