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General NPI Number Information
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NPI Number | 1487696274
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Entity Type | Organization
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Legal Business Name | CENTER FOR RELIGION & PSYCHOTHERAPY OF CHICAGO
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE SUITE 1920
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-263-4368
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Fax | 312-263-4382
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Provider Business Mailing Address
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Address Line | 30 N MICHIGAN AVE SUITE 1920
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-263-4368
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Fax | 312-263-4382
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | DR. TIMOTHY O'CONNELL
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Credential |
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Telephone | 312-263-4368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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