Provider Demographics
NPI:1235847591
Name:TORRES, RODRIGO SEBASTIAN (PHD, MA)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:SEBASTIAN
Last Name:TORRES
Suffix:
Gender:M
Credentials:PHD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E CULLERTON ST APT 925
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-1493
Mailing Address - Country:US
Mailing Address - Phone:312-925-2226
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 1830
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7407
Practice Address - Country:US
Practice Address - Phone:312-379-9476
Practice Address - Fax:312-263-1933
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071010856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical