Pediasource Therapy Specialists in Chicago - Psychologist
Pediasource Therapy Specialists - NPI 1891909594
Pediasource Therapy Specialists is a Psychologist in Chicago, Illinois. Pediasource Therapy Specialists practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Pediasource Therapy Specialists is 1891909594. The last update date is 2020-08-22.
Pediasource Therapy Specialists's current location address is 1872 N Clybourn Ave Apt 111, Chicago, Illinois. You can contact this provider via phone number 7739889905 and fax number 7734041774. The mailing address for Pediasource Therapy Specialists is 1872 N Clybourn Ave Apt 111, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediasource Therapy Specialists |
|---|---|
| Address | 1872 N Clybourn Ave Apt 111, Chicago, Illinois |
| Phone Number | 7739889905 |
| Fax Number | 7734041774 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Trukenbrod Raj Hema |
| Credentials | OTRL |
| Telephone Number | 7739889905 |
NPI Number Detail
| NPI Number | 1891909594 |
|---|---|
| Provider Enumeration Date | 2007-05-10 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1872 N Clybourn Ave Apt 111 |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606144916 |
| Phone Number | 7739889905 |
| Fax Number | 7734041774 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
|
Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
|
Post Comment/ Review Below
What is the unique identifier code issued to Pediasource Therapy Specialists by the Centers for Medicare & Medicaid Services (CMS)?
The Pediasource Therapy Specialists has been assigned the NPI (National Provider Identifier) 1891909594. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Pediasource Therapy Specialists is physically located?
The Pediasource Therapy Specialists is physically situated at the following address: 1872 N Clybourn Ave Apt 111, Chicago, IL, 606144916.
What is Pediasource Therapy Specialists's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Pediasource Therapy Specialists is Psychologist, and the taxonomy code that classifies this field of practice is 103T00000X.
On what date was the 1891909594 assigned to Pediasource Therapy Specialists?
The Pediasource Therapy Specialists was issued its 1891909594 on 2007-05-10, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Pediasource Therapy Specialists most recently updated or revised?
The information pertaining to Pediasource Therapy Specialists, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.