Individual
DR. JEFFREY C TEICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
36-045916
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045916
—
IL
01
—
1265604748
BCBS
IL
01
—
1622238
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/30/2006
Last updated
11/20/2015
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