Provider Demographics
NPI:1275726424
Name:PSYCHOLEGAL & CLINICAL ASSESSMENT SERVICES, INC
Entity Type:Organization
Organization Name:PSYCHOLEGAL & CLINICAL ASSESSMENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FORENSIC PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-903-9193
Mailing Address - Street 1:13400 S. ROUTE 59
Mailing Address - Street 2:SUITE 116, #286
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585
Mailing Address - Country:US
Mailing Address - Phone:630-903-9193
Mailing Address - Fax:
Practice Address - Street 1:2135 CITY GATE LN
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3081
Practice Address - Country:US
Practice Address - Phone:630-780-1085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.006877251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health