Provider Demographics
NPI:1417211285
Name:C. TIA MICHAUD, M.D., P.C.
Entity type:Organization
Organization Name:C. TIA MICHAUD, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-752-8426
Mailing Address - Street 1:1240 IROQUOIS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8538
Mailing Address - Country:US
Mailing Address - Phone:312-752-8426
Mailing Address - Fax:312-872-8896
Practice Address - Street 1:1240 IROQUOIS AVE STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8538
Practice Address - Country:US
Practice Address - Phone:312-752-8426
Practice Address - Fax:312-872-8896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361221482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty