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General NPI Number Information
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NPI Number | 1609288398
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Entity Type | Organization
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Legal Business Name | CENTER FOR RELIGION AND PSYCHOTHERAPY
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE STE 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 |
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Provider Business Mailing Address
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Address Line | 30 N MICHIGAN AVE STE 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 |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. CATHERINE BURRIS-SCHNUR
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Credential | DMIN, LCPC
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 178010061
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License Number State | IL
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