Healthcare Provider Details

I. General information

NPI: 1790417954
Provider Name (Legal Business Name): TOI D. BOWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 05/06/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLARITY CLINIC 333 MICHIGAN AVE SUITE 1400
CHICAGO IL
60601
US

IV. Provider business mailing address

7929 S WENTWORTH AVE
CHICAGO IL
60620-1153
US

V. Phone/Fax

Practice location:
  • Phone: 312-815-9660
  • Fax:
Mailing address:
  • Phone: 773-633-3106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1050109674
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: