Provider Demographics
NPI:1386726925
Name:SWAIN ASSOCIATES SC
Entity type:Organization
Organization Name:SWAIN ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-527-5729
Mailing Address - Street 1:405 N WABASH AVE
Mailing Address - Street 2:APT 4605
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3591
Mailing Address - Country:US
Mailing Address - Phone:312-527-5729
Mailing Address - Fax:312-527-2103
Practice Address - Street 1:405 N WABASH AVE
Practice Address - Street 2:APT 4605
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3591
Practice Address - Country:US
Practice Address - Phone:312-527-5729
Practice Address - Fax:312-527-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN31603356OtherBLUE CROSS AND BLUE SHIEL
IN31603356OtherBLUE CROSS AND BLUE SHIEL