Provider Demographics
NPI:1437916723
Name:C.L. HOWARD MEMORY & REHABILITATION SERVICES L.L.C.
Entity Type:Organization
Organization Name:C.L. HOWARD MEMORY & REHABILITATION SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-435-2497
Mailing Address - Street 1:2045 W GRAND AVE
Mailing Address - Street 2:STE B PMB 884455
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:708-435-2497
Mailing Address - Fax:
Practice Address - Street 1:2045 W GRAND AVE
Practice Address - Street 2:STE B PMB 884455
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:708-435-2497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty