Provider Demographics
NPI:1174821946
Name:HOME PSYCH SERVICES, P.C.
Entity Type:Organization
Organization Name:HOME PSYCH SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-909-9858
Mailing Address - Street 1:800 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 106-B
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3457
Mailing Address - Country:US
Mailing Address - Phone:847-867-7924
Mailing Address - Fax:847-299-4952
Practice Address - Street 1:15 SPINNING WHEEL RD STE 30
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-7651
Practice Address - Country:US
Practice Address - Phone:847-909-9858
Practice Address - Fax:773-313-3320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042712A103T00000X
IL071-005598103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071-005598OtherCLINICAL PSYCHOLOGIST LICENSE
IN20042712AOtherPSYCHOLOGIST LICENSE