Organization
JEFFERY C. TEICH M.D. S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY C TEICH M.D. (OWNER)
(847) 869-3702
Entity
Organization
Contact information
Practice address
636 CHURCH ST, SUITE #407, EVANSTON, IL 60201-4508
(847) 869-3702
(847) 869-8945
Mailing address
636 CHURCH ST, SUITE #407, EVANSTON, IL 60201-4508
(847) 869-3702
(847) 869-8945
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045916
—
IL
01
—
1622238
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
03/25/2008
Last updated
06/19/2012
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