Provider Demographics
NPI:1124578752
Name:INSIGHT THERAPEUTICS, INC.
Entity type:Organization
Organization Name:INSIGHT THERAPEUTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKLEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, NCC, LCPC
Authorized Official - Phone:847-800-9347
Mailing Address - Street 1:27W140 ROOSEVELT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1642
Mailing Address - Country:US
Mailing Address - Phone:847-800-9347
Mailing Address - Fax:847-628-0791
Practice Address - Street 1:27W140 ROOSEVELT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1642
Practice Address - Country:US
Practice Address - Phone:847-800-9347
Practice Address - Fax:847-628-0791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1205091920OtherINDIVIDUAL NPI NUMBER