Provider Demographics
NPI:1730373382
Name:THE CHICAGO STRESS RELIEF CENTER, INC
Entity type:Organization
Organization Name:THE CHICAGO STRESS RELIEF CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-412-0922
Mailing Address - Street 1:899 SKOKIE BLVD
Mailing Address - Street 2:STE 430
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4019
Mailing Address - Country:US
Mailing Address - Phone:847-412-0922
Mailing Address - Fax:847-412-0756
Practice Address - Street 1:899 SKOKIE BLVD
Practice Address - Street 2:STE 430
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4019
Practice Address - Country:US
Practice Address - Phone:847-412-0922
Practice Address - Fax:847-412-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL995390Medicare PIN