| Psychotherapy And Assessment Of Hyde Park | |
|
1525 E 55th St Suite 301b Chicago IL 60615-5512 | |
| (773) 771-8759 | |
| Not Available |
| Full Name | Psychotherapy And Assessment Of Hyde Park |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1525 E 55th St, Chicago, Illinois |
| Authorized Official Name and Position | Theresa Gregoire (MANAGING MEMBER) |
| Authorized Official Contact | 7737718759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychotherapy And Assessment Of Hyde Park 1525 E 55th St Suite 301b Chicago IL 60615-5512 Ph: () - | Psychotherapy And Assessment Of Hyde Park 1525 E 55th St Suite 301b Chicago IL 60615-5512 Ph: (773) 771-8759 |
| NPI Number | 1699171207 |
|---|---|
| Provider Enumeration Date | 11/10/2014 |
| Last Update Date | 11/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699171207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071007702 (Illinois) | Primary |
| 1041C0700X | Social Worker - Clinical | 149.015492 (Illinois) | Secondary |
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