Provider Demographics
NPI:1457333809
Name:CWIK, AUGUST J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AUGUST
Middle Name:J
Last Name:CWIK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-346-6638
Mailing Address - Fax:847-398-6348
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:SUITE 1900
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-346-6638
Practice Address - Fax:847-398-6348
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2010-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003032103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01672990OtherBC/BS
IL988810Medicare ID - Type Unspecified