Provider Demographics
NPI:1235378126
Name:MICHELLE C. DELEHANT, PH.D., INC.
Entity Type:Organization
Organization Name:MICHELLE C. DELEHANT, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:DELEHANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:815-469-6730
Mailing Address - Street 1:9990 W 190TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8189
Mailing Address - Country:US
Mailing Address - Phone:815-469-6730
Mailing Address - Fax:
Practice Address - Street 1:9990 W 190TH ST STE A
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8189
Practice Address - Country:US
Practice Address - Phone:815-469-6730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005378103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty