Provider Demographics
NPI:1386961886
Name:CHICAGO RESEARCH CENTER
Entity type:Organization
Organization Name:CHICAGO RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MALM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-282-9845
Mailing Address - Street 1:3401 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4426
Mailing Address - Country:US
Mailing Address - Phone:773-282-9845
Mailing Address - Fax:773-282-9847
Practice Address - Street 1:3401 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4426
Practice Address - Country:US
Practice Address - Phone:773-282-9845
Practice Address - Fax:773-282-9847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty