Organization
EATING RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLIN DUBOIS SCHMITZ LCSW (PRIMARY THERAPIST II)
(312) 964-4651
Entity
Organization
Contact information
Practice address
150 E HURON ST, SUITE 1300, CHICAGO, IL 60611-2999
(312) 561-0580
Mailing address
150 E HURON ST, SUITE 1300, CHICAGO, IL 60611-2999
(312) 561-0580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149019341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149019341
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/03/2017
Last updated
05/03/2017
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