Provider Demographics
NPI:1225786452
Name:PIA TODRAS, PSYD, LLC
Entity Type:Organization
Organization Name:PIA TODRAS, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:TODRAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-340-0742
Mailing Address - Street 1:601 SKOKIE AVE REAR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2033
Mailing Address - Country:US
Mailing Address - Phone:954-336-4954
Mailing Address - Fax:
Practice Address - Street 1:4709 GOLF RD STE 1150
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1252
Practice Address - Country:US
Practice Address - Phone:773-340-0742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)