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General NPI Number Information
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NPI Number | 1649441684
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Entity Type | Organization
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Legal Business Name | CHICAGO CIRCLE ASSOCIATION
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE SUITE 1511
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City | CHICAGO
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State | IL
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Zip | 60602-3662
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Country | US
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Telephone | 312-269-9180
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Fax | 847-251-5317
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Provider Business Mailing Address
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Address Line | 30 N MICHIGAN AVE SUITE 1511
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City | CHICAGO
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State | IL
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Zip | 60602-3662
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Country | US
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Telephone | 312-269-9180
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Fax | 847-251-5317
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Authorized Official
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Title or Position | TREASURER
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Name | CHARLES E TURK
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Credential | M.D.
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Telephone | 312-269-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036038856
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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