Organization
CHURCHWELL PSYCHIATRY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THOMAS CHURCHWELL M.D. (PRESIDENT)
(312) 239-3951
Entity
Organization
Contact information
Practice address
636 CHURCH ST STE 409A, EVANSTON, IL 60201-4580
(312) 239-3951
(888) 835-4696
Mailing address
636 CHURCH ST STE 409A, EVANSTON, IL 60201-4580
(312) 239-3951
(888) 835-4696
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
042620450
IL
Other
Enumeration date
08/15/2015
Last updated
08/15/2015
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