Provider Demographics
NPI:1184981151
Name:CHICAGO PSYCHIATRIC SERVICES S CORP
Entity type:Organization
Organization Name:CHICAGO PSYCHIATRIC SERVICES S CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-685-9326
Mailing Address - Street 1:8926 N GREENWOOD AVE
Mailing Address - Street 2:SUITE 167
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-5163
Mailing Address - Country:US
Mailing Address - Phone:847-685-9326
Mailing Address - Fax:847-685-9329
Practice Address - Street 1:270 SKOKIE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1612
Practice Address - Country:US
Practice Address - Phone:847-498-9320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091974103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty