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General NPI Number Information
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NPI Number | 1598586216
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Entity Type | Organization
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Legal Business Name | TRANSFORMATION MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 171 N ABERDEEN ST STE 400
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City | CHICAGO
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State | IL
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Zip | 60607-1670
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Country | US
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Telephone | 646-509-8576
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Fax |
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Provider Business Mailing Address
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Address Line | 171 N ABERDEEN ST STE 400
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City | CHICAGO
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State | IL
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Zip | 60607-1670
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN MCCAULEY
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Credential | MD
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Telephone | 309-706-4315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #8
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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 |
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