Provider Demographics
NPI:1245243088
Name:SKOUBIS, WILLIAM J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SKOUBIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 RICKERT DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0951
Mailing Address - Country:US
Mailing Address - Phone:630-476-0429
Mailing Address - Fax:630-717-1165
Practice Address - Street 1:1288 RICKERT DR
Practice Address - Street 2:SUITE 220
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-0951
Practice Address - Country:US
Practice Address - Phone:630-476-0429
Practice Address - Fax:630-717-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005420103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist