Provider Demographics
NPI:1629806567
Name:CHICAGO CHILD PSYCHIATRY ASSOCIATES LLC
Entity type:Organization
Organization Name:CHICAGO CHILD PSYCHIATRY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SMAJKIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-893-5701
Mailing Address - Street 1:932 S BODIN ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4360
Mailing Address - Country:US
Mailing Address - Phone:313-893-5701
Mailing Address - Fax:
Practice Address - Street 1:932 S BODIN ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4360
Practice Address - Country:US
Practice Address - Phone:313-893-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty