Provider Demographics
NPI:1235146374
Name:CHICAGO BEHAVIOR CONSULTANTS, INC.
Entity Type:Organization
Organization Name:CHICAGO BEHAVIOR CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-654-3484
Mailing Address - Street 1:1458 W BRYN MAWR AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4225
Mailing Address - Country:US
Mailing Address - Phone:773-654-3484
Mailing Address - Fax:773-654-3484
Practice Address - Street 1:655 W IRVING PARK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3123
Practice Address - Country:US
Practice Address - Phone:773-654-3484
Practice Address - Fax:773-654-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001673723OtherBLUE CROSS BLUE SHIELD