Churchwell Psychiatry, S.C.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

042620450 Issued in IL

Legal business name

CHURCHWELL PSYCHIATRY, S.C.

Practice address

636 Church St Ste 409a
Evanston, IL 60201-4580

Phone

(312) 239-3951

Fax

(888) 835-4696

NPI assigned

Aug 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michael Thomas Churchwell, M.D.

Title

President

Phone

(312) 239-3951

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439596800000",
    "number": "1356717151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 409A",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "312-239-3951",
            "fax_number": "888-835-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 409A",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "312-239-3951",
            "fax_number": "888-835-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHWELL PSYCHIATRY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-15",
        "last_updated": "2015-08-15",
        "status": "A",
        "authorized_official_last_name": "CHURCHWELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-239-3951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "042620450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Chuang
• Deborah Chun, NP
• Nolan Kin Ming Chun, D.D.S
• Penuel Chun
• Alissa Karen Chung, PH.D.
• Kinga A Chybowska, APN-CNP
• Thomas Lee Cibull, M.D.
• John Anthony Cieslak III, M.D., PH.D.
• Angelica Cintron, APN-CRNA
• Adam T Cios, M.D.

• Adult Mental Health Clinic/Center in Evanston, IL
• Providers in Evanston, 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 Aug 15, 2015; 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.