Provider Demographics
NPI:1063017366
Name:ADVANCE NEURO PSYCHOLOGY AND ASSESSMENT, INC
Entity Type:Organization
Organization Name:ADVANCE NEURO PSYCHOLOGY AND ASSESSMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-558-5533
Mailing Address - Street 1:3100 DUNDEE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2452
Mailing Address - Country:US
Mailing Address - Phone:847-907-5010
Mailing Address - Fax:
Practice Address - Street 1:3100 DUNDEE RD STE 403
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2452
Practice Address - Country:US
Practice Address - Phone:847-907-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty