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General NPI Number Information
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NPI Number | 1144663139
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Entity Type | Organization
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Legal Business Name | CLINICAL RESEARCH INSTITUTE, INC.
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 5646 SAINT CHARLES RD SUITE C
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City | BERKELEY
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State | IL
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Zip | 60163-1148
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Country | US
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Telephone | 630-544-7475
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Fax |
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Provider Business Mailing Address
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Address Line | 5646 SAINT CHARLES RD SUITE C
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City | BERKELEY
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State | IL
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Zip | 60163-1148
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Country | US
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Telephone | 630-544-7475
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. GARY R. JOHNSON
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Credential | D.D.S.
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Telephone | 630-544-7475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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