Provider Demographics
NPI:1518118934
Name:WENDY CHARNESS, PHD
Entity Type:Organization
Organization Name:WENDY CHARNESS, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARNESS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-421-5343
Mailing Address - Street 1:333 E ONTARIO ST
Mailing Address - Street 2:SUITE 4401B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4804
Mailing Address - Country:US
Mailing Address - Phone:312-421-5343
Mailing Address - Fax:
Practice Address - Street 1:333 E ONTARIO ST
Practice Address - Street 2:SUITE 4401B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4804
Practice Address - Country:US
Practice Address - Phone:312-421-5343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty