Provider Demographics
NPI:1326751405
Name:SHAMSI PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:SHAMSI PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TABISH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMSI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-234-8349
Mailing Address - Street 1:7627 LAKE ST
Mailing Address - Street 2:STE 206 #A90
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1878
Mailing Address - Country:US
Mailing Address - Phone:773-234-5644
Mailing Address - Fax:
Practice Address - Street 1:7627 LAKE ST
Practice Address - Street 2:STE 206 #A90
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1878
Practice Address - Country:US
Practice Address - Phone:773-234-5644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty