=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922570159
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CREATIVE COMMUNICATIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2018
-----------------------------------------------------
Last Update Date | 10/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 737 W WRIGHTWOOD AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60614-2539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-672-9815
-----------------------------------------------------
Fax | 312-275-8553
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1722 W FARRAGUT AVE APT 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60640-2012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-672-9815
-----------------------------------------------------
Fax | 312-216-0746
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DANIEL BRIAN TOURIGNY
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 314-696-9310
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------