Charles C. Anderson Ed.D Reg Psy

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

071.002741 Issued in IL

Legal business name

CHARLES C. ANDERSON ED.D REG PSY

Practice address

2030 N Magnolia Ave
Chicago, IL 60614-4010

Phone

(847) 398-1717

Fax

(773) 348-5271

NPI assigned

Jan 30, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles C. Anderson, ED.D

Title

President

Phone

(847) 398-1717

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1194963082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N KENNICOTT AVE",
            "address_2": "B",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047813",
            "telephone_number": "847-398-1717",
            "fax_number": "773-348-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 N MAGNOLIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144010",
            "telephone_number": "847-398-1717",
            "fax_number": "773-348-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES C. ANDERSON ED.D REG PSY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-398-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071.002741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Charest, MD
• Chariots on Wheels Transport
• Charism Counseling Center
• Ekaterina Margaret Charland, LCPC
• Charles B Holmes, MD, SC
• Charles Caplis DPM SC
• Charles D. Campbell, MD LTD
• Charles Drexler Drugs Inc
• Charles Drueck, M.D., S.C.
• Charles F Small LCSW LLC

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.