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General NPI Number Information
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NPI Number | 1598024200
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Entity Type | Organization
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Legal Business Name | KAREN TAYLOR CRAWFORD AND ASSOCIATES
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 301 E. 47TH STREET
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City | CHICAGO
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State | IL
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Zip | 60653-3656
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Country | US
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Telephone | 773-844-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 9745 S VANDERPOEL AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1231
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Country | US
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Telephone | 773-203-6156
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. THEODORE J CRAWFORD
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Credential |
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Telephone | 312-388-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 036056639
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License Number State | IL
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