Terrence James Koller in Evanston - Clinical
Terrence James Koller - NPI 1487647715
Terrence James Koller is a Clinical in Evanston, Illinois. Terrence James Koller practices all healthcare services and medical treatments related to Clinical. The NPI Number for Terrence James Koller is 1487647715. The last update date is 2011-10-07.
Terrence James Koller's current location address is 2317 Hartrey Ave, Evanston, Illinois. You can contact this provider via phone number 8478642317. The mailing address for Terrence James Koller is 2317 Hartrey Ave, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Terrence James Koller |
|---|---|
| Address | 2317 Hartrey Ave, Evanston, Illinois |
| Phone Number | 8478642317 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1487647715 |
|---|---|
| Provider Enumeration Date | 2005-08-23 |
| Last Updated Date | 2011-10-07 |
Provider Mailing Address Detail
| Address | 2317 Hartrey Ave |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 602012552 |
| Phone Number | 8478642317 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71002716 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1672636 | IL | BLUE CROSS/BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Terrence James Koller by the Centers for Medicare & Medicaid Services (CMS)?
The Terrence James Koller has been assigned the NPI (National Provider Identifier) 1487647715. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Terrence James Koller is geographically located?
The Terrence James Koller is physically situated at the following location: 2317 Hartrey Ave, Evanston, IL, 602012552.
What is Terrence James Koller's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Terrence James Koller is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1487647715 to Terrence James Koller?
The Centers for Medicare & Medicaid Services originally issued the 1487647715 to Terrence James Koller on 2005-08-23.
When was the information regarding Terrence James Koller most recently updated?
The details pertaining to the Terrence James Koller, including its address, specialty, and other relevant information, were last refreshed on 2011-10-07.