Healthcare Provider Details

I. General information

NPI: 1457333809
Provider Name (Legal Business Name): AUGUST J CWIK PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE SUITE 1900
CHICAGO IL
60602-3402
US

IV. Provider business mailing address

30 N MICHIGAN AVE SUITE 1900
CHICAGO IL
60602-3402
US

V. Phone/Fax

Practice location:
  • Phone: 312-346-6638
  • Fax: 847-398-6348
Mailing address:
  • Phone: 312-346-6638
  • Fax: 847-398-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number071003032
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: