Provider Demographics
NPI:1417476599
Name:CHICAGO TESTPREP.ORG, LLC
Entity Type:Organization
Organization Name:CHICAGO TESTPREP.ORG, LLC
Other - Org Name:CTP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/CHIEF PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-360-8852
Mailing Address - Street 1:1220 N HOYNE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3190
Mailing Address - Country:US
Mailing Address - Phone:773-360-8852
Mailing Address - Fax:773-347-1777
Practice Address - Street 1:1220 N HOYNE AVE STE B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3190
Practice Address - Country:US
Practice Address - Phone:773-360-8852
Practice Address - Fax:773-347-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.002712103T00000X
IL149.0021421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty