Ray Edward Quackenbush in Chicago - Clinical
Ray Edward Quackenbush - NPI 1619970357
Ray Edward Quackenbush is a Clinical in Chicago, Illinois. Ray Edward Quackenbush practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ray Edward Quackenbush is 1619970357. The last update date is 2007-07-08.
Ray Edward Quackenbush's current location address is 4801 W Peterson Ave, Chicago, Illinois. You can contact this provider via phone number 7732863100 and fax number 7737777543. The mailing address for Ray Edward Quackenbush is 4801 W Peterson Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ray Edward Quackenbush |
|---|---|
| Address | 4801 W Peterson Ave, Chicago, Illinois |
| Phone Number | 7732863100 |
| Fax Number | 7737777543 |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1619970357 |
|---|---|
| Provider Enumeration Date | 2005-05-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4801 W Peterson Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 6064657310 |
| Phone Number | 7732863100 |
| Fax Number | 7737777543 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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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 Ray Edward Quackenbush's 1619970357?
The Ray Edward Quackenbush's NPI (National Provider Identifier) Number is 1619970357. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Ray Edward Quackenbush is located?
The Ray Edward Quackenbush is situated at the following address: 4801 W Peterson Ave, Chicago, IL, 6064657310.
What is the Ray Edward Quackenbush's area of specialization and corresponding taxonomy classification?
The Ray Edward Quackenbush's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
On what date did Ray Edward Quackenbush receive its 1619970357 assignment from the Centers for Medicare & Medicaid Services?
The Ray Edward Quackenbush was assigned its 1619970357 on 2005-05-26, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Ray Edward Quackenbush most recently updated?
The details pertaining to the Ray Edward Quackenbush, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
NPI Number: 1346246931
Address: 35 Jolley Dr, Bloomfield, CT