Provider Demographics
NPI:1386329324
Name:DUBOIS, CHRIS
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S MICHIGAN AVE STE 928
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1399
Mailing Address - Country:US
Mailing Address - Phone:312-248-3190
Mailing Address - Fax:
Practice Address - Street 1:410 S MICHIGAN AVE STE 928
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1399
Practice Address - Country:US
Practice Address - Phone:312-248-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional