Individual
BRIAN GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
441 E ERIE ST APT 2511, CHICAGO, IL 60611-4426
(312) 475-1576
Mailing address
441 E ERIE ST APT 2511, CHICAGO, IL 60611-4426
(312) 475-1576
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01673210
BLUE CROSS
IL
Enumeration date
12/20/2006
Last updated
07/08/2007
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