Healthcare Provider Details

I. General information

NPI: 1245853308
Provider Name (Legal Business Name): AUGUST J CWIK PSY D LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2020
Last Update Date: 05/24/2020
Certification Date: 05/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE STE 1900
CHICAGO IL
60602-3624
US

IV. Provider business mailing address

2800 N LAKE SHORE DR APT 3017
CHICAGO IL
60657-6275
US

V. Phone/Fax

Practice location:
  • Phone: 312-346-6638
  • Fax: 773-857-7041
Mailing address:
  • Phone: 847-502-6308
  • Fax: 773-857-7041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AUGUST J CWIK
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSY.D.
Phone: 847-502-6308