| Chicago Clinical Associates | |
|
111 N Wabash Ave Suite 822 Chicago IL 60602-1903 | |
| (312) 436-1657 | |
| (312) 284-4505 |
| Full Name | Chicago Clinical Associates |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 111 N Wabash Ave, Chicago, Illinois |
| Authorized Official Name and Position | David Hoover (PRESIDENT) |
| Authorized Official Contact | 3124361657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Clinical Associates 111 N Wabash Ave Ste 1400 Chicago IL 60602-3074 Ph: (312) 436-1657 | Chicago Clinical Associates 111 N Wabash Ave Suite 822 Chicago IL 60602-1903 Ph: (312) 436-1657 |
| NPI Number | 1619217064 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 9335547587 |
|---|---|
| Medicare Enrollment ID | O20211001002745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619217064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180007852 (Illinois) | Primary |
| Provider Name | Robert E Puls |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992850044 PECOS PAC ID: 0042315624 Enrollment ID: I20070411000155 |
| Provider Name | Tiffany Clomax |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700435252 PECOS PAC ID: 3173913456 Enrollment ID: I20211130001565 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
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