Provider Demographics
NPI:1295040681
Name:J. HOWARD AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:J. HOWARD AND ASSOCIATES, INC.
Other - Org Name:THE CENTER FOR OPTIMAL LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-474-9029
Mailing Address - Street 1:444 N MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5118
Mailing Address - Country:US
Mailing Address - Phone:630-474-9029
Mailing Address - Fax:630-474-9028
Practice Address - Street 1:444 N MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5118
Practice Address - Country:US
Practice Address - Phone:630-474-9029
Practice Address - Fax:630-474-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036123850261QM0850X
IL180006925261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty