The Chicago Integrative Center for Psychiatry LLC

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

36117225 Issued in IL

Legal business name

THE CHICAGO INTEGRATIVE CENTER FOR PSYCHIATRY LLC

Practice address

900 North Shore Dr
Suite 120
Lake Bluff, IL 60044-2243

Phone

(847) 615-1698

Fax

(847) 615-1697

NPI assigned

Jan 14, 2014

Last updated

Feb 26, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Erin Bright

Title

Office Administrator

Phone

(847) 770-1241

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1831511690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NORTH SHORE DR",
            "address_2": "SUITE 120",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442243",
            "telephone_number": "847-615-1698",
            "fax_number": "847-615-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NORTH SHORE DR",
            "address_2": "SUITE 120",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442243",
            "telephone_number": "847-615-1698",
            "fax_number": "847-615-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHICAGO INTEGRATIVE CENTER FOR PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "BRIGHT",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-770-1241",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "IL",
            "license": "36117225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescribing (Medical) Psychologist in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Prescribing (Medical) Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; 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.