Healthcare Provider Details

I. General information

NPI: 1922570159
Provider Name (Legal Business Name): CREATIVE COMMUNICATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 10/28/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 W WRIGHTWOOD AVE
CHICAGO IL
60614-2539
US

IV. Provider business mailing address

1722 W FARRAGUT AVE APT 2
CHICAGO IL
60640-2012
US

V. Phone/Fax

Practice location:
  • Phone: 773-672-9815
  • Fax: 312-275-8553
Mailing address:
  • Phone: 773-672-9815
  • Fax: 312-216-0746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL BRIAN TOURIGNY
Title or Position: OWNER
Credential: BCBA
Phone: 314-696-9310