Provider Demographics
NPI:1033570296
Name:PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL SERVICES, PC
Other - Org Name:CENTER OF POLICE PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRICKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-428-0159
Mailing Address - Street 1:655 W IRVING PARK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3123
Mailing Address - Country:US
Mailing Address - Phone:312-878-8585
Mailing Address - Fax:312-878-8585
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-878-8585
Practice Address - Fax:317-878-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1336305671OtherNPI