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NPI Code Detail

MEDICARE: CREATIVE COMMUNICATIONS, LLC

MEDICARE: CREATIVE COMMUNICATIONS, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1922570159
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATIVE COMMUNICATIONS, LLC
Provider Business Mailing Address
First Line : 1722 W FARRAGUT AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60640-2012
Country : US
Telephone Number : 773-672-9815
Fax Number : 312-216-0746
Provider Business Practice Location Address
First Line : 737 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2539
Country : US
Telephone Number : 773-672-9815
Fax Number : 312-275-8553
Authorized Official
Title or Position : OWNER
Name : DANIEL BRIAN TOURIGNY
Credential : BCBA
Telephone Number : 314-696-9310
Provider Enumeration Date : 12/28/2018
Last Update Date : 10/28/2024

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Directions to “CREATIVE COMMUNICATIONS, LLC ” Practice Location

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