Timothy W Pedigo in Matteson - Psychologist
Timothy W Pedigo - NPI 1861586760
Timothy W Pedigo is a Psychologist in Matteson, Illinois. Timothy W Pedigo practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Timothy W Pedigo is 1861586760. The last update date is 2007-07-08.
Timothy W Pedigo's current location address is 3624 W 216th St, Matteson, Illinois. You can contact this provider via phone number 7084814080 and fax number 7084817725. The mailing address for Timothy W Pedigo is 3624 W 216th St, Matteson, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Timothy W Pedigo |
|---|---|
| Address | 3624 W 216th St, Matteson, Illinois |
| Phone Number | 7084814080 |
| Fax Number | 7084817725 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1861586760 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3624 W 216th St |
|---|---|
| City | Matteson |
| State | Illinois (IL) |
| Post Code | 604432713 |
| Phone Number | 7084814080 |
| Fax Number | 7084817725 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 71003996 |
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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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1636410 | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Timothy W Pedigo by the Centers for Medicare & Medicaid Services?
The Timothy W Pedigo has been issued the NPI (National Provider Identifier) 1861586760, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Timothy W Pedigo?
The Timothy W Pedigo is situated at 3624 W 216Th St, in the city of Matteson, state of IL, with the zip code 604432713.
What is the Timothy W Pedigo's specialty and taxonomy code?
The Timothy W Pedigo's specialty is Psychologist, and the corresponding taxonomy code is 103T00000X.
On what date did Timothy W Pedigo receive its 1861586760 assignment from the Centers for Medicare & Medicaid Services?
The Timothy W Pedigo was assigned its 1861586760 on 2006-10-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Timothy W Pedigo last refreshed?
The information related to the Timothy W Pedigo, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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