Provider Demographics
NPI:1326308750
Name:A BALANCED OUTLOOK PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:A BALANCED OUTLOOK PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:BILLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-420-3045
Mailing Address - Street 1:6109 S MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-4331
Mailing Address - Country:US
Mailing Address - Phone:312-420-3045
Mailing Address - Fax:
Practice Address - Street 1:6109 S MEADE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4331
Practice Address - Country:US
Practice Address - Phone:312-420-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL248.000583251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health