Provider Demographics
NPI:1033517412
Name:WOOD NEUROPSYCHOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:WOOD NEUROPSYCHOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-636-8704
Mailing Address - Street 1:806 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4834
Mailing Address - Country:US
Mailing Address - Phone:847-636-8704
Mailing Address - Fax:847-692-2993
Practice Address - Street 1:1600 GOLF RD STE 1200
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-4229
Practice Address - Country:US
Practice Address - Phone:847-636-8704
Practice Address - Fax:847-692-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005574103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty