Constance Anita Fullilove in Chicago - Clinical
Constance Anita Fullilove - NPI 1235209529
Constance Anita Fullilove is a Clinical in Chicago, Illinois. Constance Anita Fullilove practices all healthcare services and medical treatments related to Clinical. The NPI Number for Constance Anita Fullilove is 1235209529. The last update date is 2021-04-23.
Constance Anita Fullilove's current location address is 205 W Randolph St Ste 830, Chicago, Illinois. You can contact this provider via phone number 3122361498. The mailing address for Constance Anita Fullilove is 205 W Randolph St Ste 830, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Constance Anita Fullilove |
|---|---|
| Address | 205 W Randolph St Ste 830, Chicago, Illinois |
| Phone Number | 3122361498 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1235209529 |
|---|---|
| Provider Enumeration Date | 2006-11-08 |
| Last Updated Date | 2021-04-23 |
Provider Mailing Address Detail
| Address | 205 W Randolph St Ste 830 |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606061815 |
| Phone Number | 3122361498 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 071-002239 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Constance Anita Fullilove by the Centers for Medicare & Medicaid Services?
The Constance Anita Fullilove has been assigned the NPI (National Provider Identifier) 1235209529 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Constance Anita Fullilove is located?
The Constance Anita Fullilove is situated at the following address: 205 W Randolph St Ste 830, Chicago, IL, 606061815.
What is Constance Anita Fullilove's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Constance Anita Fullilove's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc0700X.
On what date did the Constance Anita Fullilove receive the assignment of its 1235209529 from the Centers for Medicare & Medicaid Services?
The Constance Anita Fullilove was issued its 1235209529 by the Centers for Medicare & Medicaid Services on 2006-11-08.
When was the information regarding Constance Anita Fullilove, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Constance Anita Fullilove, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-04-23.