| Jeffery C. Teich M.d. S.c. | |
|
636 Church St Suite #407 Evanston IL 60201-4508 | |
| (847) 869-3702 | |
| (847) 869-8945 |
| Full Name | Jeffery C. Teich M.d. S.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 636 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Jeffrey C Teich (OWNER) |
| Authorized Official Contact | 8478693702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffery C. Teich M.d. S.c. 636 Church St Suite #407 Evanston IL 60201-4508 Ph: (847) 869-3702 | Jeffery C. Teich M.d. S.c. 636 Church St Suite #407 Evanston IL 60201-4508 Ph: (847) 869-3702 |
| NPI Number | 1265604748 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 06/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265604748 | NPI | - | NPPES |
| 036045916 | Medicaid | IL | |
| 1622238 | Other | IL | BLUE CROSS BLUE SHIELD IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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