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General NPI Number Information
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NPI Number | 1043297401
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Entity Type | Organization
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Legal Business Name | INSIGHT CHICAGO, INC.
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 2525 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2333
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Country | US
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Telephone | 312-567-2000
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Fax | 312-567-6156
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Provider Business Mailing Address
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Address Line | PO BOX 776473
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City | CHICAGO
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State | IL
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Zip | 60677-6473
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Country | US
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Telephone | 312-567-2000
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Fax | 312-638-8320
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ROBIN COLE
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Credential |
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Telephone | 810-275-9333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 362170152
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License Number State | IL
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