Provider Demographics
NPI:1023991056
Name:PRESIDENT, NEIL CHRISTIAN
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:CHRISTIAN
Last Name:PRESIDENT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NEIL
Other - Middle Name:CHRISTIAN
Other - Last Name:PRESIDENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2567 CLARKE ST
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1656
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2567 CLARKE ST
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1656
Practice Address - Country:US
Practice Address - Phone:832-459-6620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty