DR. CHRISTOPHER CARL MUTH (NPI# 1700105970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700105970 |
| Entity Type | Individual |
| Full Name | DR. CHRISTOPHER CARL MUTH |
| Credential | M.D. |
| Practice Address |
1725 W Harrison St Ste 1106 Chicago IL 60612-3845 |
| Practice Telephone | 3129424500 |
| Mailing Telephone | 3129424500 |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 125:057571 | IL | Allopathic & Osteopathic Physicians |
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
036-143894 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201311130 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 611 E Douglas Rd Ste 305, Mishawaka, IN 465451467 | 5743356450 | 5743350643 |
| Street Address |
1725 W HARRISON ST STE 1106 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503768 | Blake Beehler | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2020-06-24 |
| 1104441062 | Teona Munteanu | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2020-06-16 |
| 1164876553 | Zachary Benjamin Bulwa | Internal Medicine | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2016-04-21 |
| 1831525898 | Naira Arellano | Registered Nurse | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2013-09-23 |
| 1760725469 | Natalie Witek | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612 | 2013-04-01 |
| 1992060271 | Fabian Sierra Morales | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2012-07-12 |
| 1629335450 | Thomas Jack Shoemaker | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2012-04-18 |
| 1750675187 | Joo Yeon Nam | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2011-06-02 |
| 1346531282 | Lauren May Koffman | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2011-04-26 |
| 1356654735 | Ivan Rocha Ferreira Da Silva | Psychiatry & Neurology | 1725 W Harrison St Ste 1106, Chicago, IL 60612-3845 | 2010-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
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| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497174353 | Atif Sheikh | Psychiatry & Neurology | 600 N Mcclurg Ct Apt 3205a, Chicago, IL 60611-6610 | 2014-04-08 |
| 1235557927 | Akash D Patel | Psychiatry & Neurology | 1801 W Taylor St Ste 4e, Chicago, IL 60612-4795 | 2014-03-31 |
| 1093337412 | Sumayyah Abumurad | Psychiatry & Neurology | 5841 S Maryland Ave Rm J-141, Mc2030, S231, Chicago, IL 60637-1443 | 2020-05-07 |
| 1023558376 | Adam Jackson | Psychiatry & Neurology | 55 W Chestnut St, Chicago, IL 60610-3347 | 2017-03-06 |
| 1831540111 | Christopher Veys | Psychiatry & Neurology | 1725 W Harrison St Ste 885, Chicago, IL 60612-3841 | 2016-06-28 |
| 1588027924 | Geeta Verma | Psychiatry & Neurology | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2016-04-02 |
| 1326459553 | Ahmad Daif | Psychiatry & Neurology | 5841 S Maryland Ave # Mc2030, Chicago, IL 60637-1447 | 2014-05-09 |
| 1124394127 | Diana Mnatsakanova | Psychiatry & Neurology | 1801 W Taylor St, Chicago, IL 60612-4795 | 2012-03-24 |
| 1619183852 | Adriana Carmenza Bermeo Ovalle | Psychiatry & Neurology | 1725 W Harrison St, Suite 1106, Chicago, IL 60612-3841 | 2007-05-15 |
| 1972694537 | Mary Louise Tomyanovich | Psychiatry & Neurology | 820 S Damen Ave, M.p. # 127, Chicago, IL 60612-3728 | 2006-09-27 |
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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.