Provider Demographics
NPI:1104375666
Name:EXIST CHICAGO, P.C.
Entity Type:Organization
Organization Name:EXIST CHICAGO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:ZURAWIC
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-858-5212
Mailing Address - Street 1:4728 N PAULINA ST
Mailing Address - Street 2:3N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4431
Mailing Address - Country:US
Mailing Address - Phone:847-858-5212
Mailing Address - Fax:
Practice Address - Street 1:1733 PARK ST STE 100
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4863
Practice Address - Country:US
Practice Address - Phone:847-858-5212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008088103T00000X, 103TA0700X, 103TC0700X, 103TF0000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty