Provider Demographics
NPI:1316015829
Name:MAVROLAS, CATHY MOLLIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:MOLLIE
Last Name:MAVROLAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 N KING GEORGE CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2764
Mailing Address - Country:US
Mailing Address - Phone:847-359-0589
Mailing Address - Fax:
Practice Address - Street 1:E. 65TH AT LAKE MICHIGAN
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649
Practice Address - Country:US
Practice Address - Phone:773-256-5722
Practice Address - Fax:773-363-7664
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist