Mr David James Derita, PHD is a
Psychologist - Clinical based in Tower Lakes, Illinois. Mr David James Derita is licensed to practice in Illinois (license number 071-002434) and his current practice location is
215 W Lake Shore Dr, Tower Lakes, Illinois. He can be reached at his office (for appointments etc.) via phone at
(847) 526-6557.
NPI number for Mr David James Derita is 1124253547 and his current mailing address is 215 W Lake Shore Dr, Tower Lakes, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124253547.
Healthcare Provider's Profile
Full Name | Mr David James Derita |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 215 W Lake Shore Dr, Tower Lakes, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1124253547
- Provider Enumeration Date: 05/29/2009
- Last Update Date: 05/29/2009
Medical Identifiers
Medical identifiers for Mr David James Derita such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124253547 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 071-002434 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr David James Derita is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr David James Derita, PHD 215 W Lake Shore Dr, Tower Lakes, IL 60010-1130 Ph: (847) 526-6557 | Mr David James Derita, PHD 215 W Lake Shore Dr, Tower Lakes, IL 60010-1130 Ph: (847) 526-6557 |
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