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Individual

DR. MICHAEL EDWARD CREMERIUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
7447 W TALCOTT AVE, SUITE 333, CHICAGO, IL 60631-3745
(773) 631-8483
(773) 631-8506
Mailing address
7447 W TALCOTT AVE, SUITE 333, CHICAGO, IL 60631-3745
(773) 631-8483
(773) 631-8506

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02205932
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/27/2005
Last updated
07/08/2007
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