| Churchwell Psychiatry, S.c. | |
|
636 Church St Ste 409a Evanston IL 60201-4580 | |
| (312) 239-3951 | |
| (888) 835-4696 |
| Full Name | Churchwell Psychiatry, S.c. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 636 Church St Ste 409a, Evanston, Illinois |
| Authorized Official Name and Position | Michael Thomas Churchwell (PRESIDENT) |
| Authorized Official Contact | 3122393951 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Churchwell Psychiatry, S.c. 636 Church St Ste 409a Evanston IL 60201-4580 Ph: (312) 239-3951 | Churchwell Psychiatry, S.c. 636 Church St Ste 409a Evanston IL 60201-4580 Ph: (312) 239-3951 |
| NPI Number | 1356717151 |
|---|---|
| Provider Enumeration Date | 08/15/2015 |
| Last Update Date | 08/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356717151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 042620450 (Illinois) | Primary |
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