Provider Demographics
NPI:1255667432
Name:CHILDREN'S NEUROPSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:CHILDREN'S NEUROPSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:STRESS
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-706-0940
Mailing Address - Street 1:333 N MICHIGAN AVE STE 2122
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4034
Mailing Address - Country:US
Mailing Address - Phone:773-706-0940
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 2122
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4034
Practice Address - Country:US
Practice Address - Phone:773-706-0940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007066103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty