MEDICARE: CHICAGO PSYCHOANALYTIC INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	103T00000X	Psychologist

General Provider Information

NPI Number	:	1306856950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO PSYCHOANALYTIC INSTITUTE

Provider Business Mailing Address
First Line	:	8 S MICHIGAN AVE STE 700
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-3463
Country	:	US
Telephone Number	:	312-922-7474
Fax Number	:	312-922-5656

Provider Business Practice Location Address
First Line	:	8 S MICHIGAN AVE FL 7
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-3357
Country	:	US
Telephone Number	:	312-922-7474
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID M BROOKS
Credential	:	PHD, PSYD
Telephone Number	:	312-922-7474

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	09/15/2023

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