CRAWFORD AVENUE GROUP INC (NPI# 1013409366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013409366 |
| Entity Type | Organization |
| Organization Name | CRAWFORD AVENUE GROUP INC |
| Practice Address |
2530 Crawford Ave Ste 206 Evanston IL 60201-4959 |
| Practice Telephone | 8478754411 |
| Enumeration Date | 2018-06-02 |
| Last Update Date | 2018-06-02 |
| Authorized Official Name | KELLI KLINGER (PRESIDENT) |
| Authorized Official Telephone | 8478754411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149003065 | IL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071007124 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | TYPE 1-NPI | 1619019080 | 01 |
| IL | TYPE 1-NPI | 1891819363 | 01 |
| IL | BLUE CROSS BLUE SHIELD OF ILLINOIS | 0000603083 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2530 Crawford Ave Ste 212, Evanston, IL 602014959 | 8476041945 | 8477331217 |
| Street Address |
2530 CRAWFORD AVE STE 206 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201-4959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| Find all providers in zip 60201 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
| 1992346233 | Kiran Ramesh Mirchandani | Psychologist | 1740 Ridge Ave Ste 22, Evanston, IL 60201-5918 | 2019-10-07 |
| 1982181533 | Melissa Perrin | Psychologist | 2530 Crawford Ave Ste 203, Evanston, IL 60201-4959 | 2018-07-26 |
| 1689165250 | Mona Sue Weissmark | Psychologist | 737 Clinton Pl, Evanston, IL 60201-1765 | 2018-05-19 |
| 1063920957 | Tamara Miriam Claman | Psychologist | 1718 Sherman Ave Ste 210, Evanston, IL 60201-5610 | 2018-01-13 |
| 1619480720 | Kaelin Emery | Psychologist | 820 Davis St Ste 455, Evanston, IL 60201-4447 | 2017-11-10 |
| 1861905051 | Dr. Tari Mack, Inc. | Psychologist | 636 Church St Ste 415, Evanston, IL 60201-4580 | 2017-11-09 |
| 1639535396 | Alissa Levy Chung, Ph.d., Inc. | Psychologist | 704 South Blvd, Evanston, IL 60202-2908 | 2016-01-12 |
| 1114359213 | Dr Savage Psychological Services PC | Psychologist | 2550 Crawford Ave Ste 12, Evanston, IL 60201-4987 | 2013-07-31 |
| 1710320080 | Marni B Rosen | Psychologist | 2130 Green Bay Rd, Evanston, IL 60201-3026 | 2013-04-16 |
| Find all providers in EVANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.