Provider Demographics
NPI:1154511103
Name:MCROBERTS, HEATHER LYNN (PSYD)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN
Last Name:MCROBERTS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 W CORTEZ ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3540
Mailing Address - Country:US
Mailing Address - Phone:773-203-5430
Mailing Address - Fax:
Practice Address - Street 1:1200 HARGER RD
Practice Address - Street 2:SUITE 505
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1805
Practice Address - Country:US
Practice Address - Phone:630-571-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007944103TC0700X, 103TC2200X
103TA0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy