Provider Demographics
NPI:1326136425
Name:CHRONIAK, CHRISTOPHER PAUL (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:CHRONIAK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 S PLYMOUTH CT
Mailing Address - Street 2:UNIT E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2704
Mailing Address - Country:US
Mailing Address - Phone:312-588-0870
Mailing Address - Fax:312-588-0890
Practice Address - Street 1:122 S MICHIGAN AVE
Practice Address - Street 2:SUITE 1457
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6191
Practice Address - Country:US
Practice Address - Phone:312-786-9772
Practice Address - Fax:312-588-0890
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212801Medicare ID - Type Unspecified