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General NPI Number Information
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NPI Number | 1861632192
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Entity Type | Organization
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Legal Business Name | CHICAGO DEPRESSION AND ANXIETY SPECIALISTS, SC
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 330 W DIVERSEY PKWY APT 2707
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City | CHICAGO
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State | IL
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Zip | 60657-6209
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Country | US
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Telephone | 312-985-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 330 W DIVERSEY PKWY APT 2707
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City | CHICAGO
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State | IL
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Zip | 60657-6209
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Country | US
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Telephone | 312-985-4431
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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. WILLIAM S GILMER
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Credential | M.D.
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Telephone | 312-895-4431
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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 | 042619464036076721
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License Number State | IL
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