Provider Demographics
NPI:1760716146
Name:CHILDREN'S RESEARCH TRIANGLE
Entity Type:Organization
Organization Name:CHILDREN'S RESEARCH TRIANGLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHASNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-726-4011
Mailing Address - Street 1:180 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7401
Mailing Address - Country:US
Mailing Address - Phone:312-726-4011
Mailing Address - Fax:312-726-4021
Practice Address - Street 1:180 N MICHIGAN AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7401
Practice Address - Country:US
Practice Address - Phone:312-726-4011
Practice Address - Fax:312-726-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable