Provider Demographics
NPI:1851726301
Name:CIRIO THERAPY
Entity Type:Organization
Organization Name:CIRIO THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CIRIO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:312-451-8980
Mailing Address - Street 1:175 N FRANKLIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1832
Mailing Address - Country:US
Mailing Address - Phone:312-451-8980
Mailing Address - Fax:312-602-1002
Practice Address - Street 1:1740 RIDGE AVE
Practice Address - Street 2:SUITE 200 C
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5918
Practice Address - Country:US
Practice Address - Phone:312-451-8980
Practice Address - Fax:312-602-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166-000786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1598959868OtherINDIVIDUAL NPI #
IL12387317OtherCAQH ID#