Provider Demographics
NPI:1346415015
Name:CUNNINGHAM, LLOYD THOMAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:THOMAS
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 W. FRONTAGE RD. SUITE 32
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093
Mailing Address - Country:US
Mailing Address - Phone:773-610-3766
Mailing Address - Fax:
Practice Address - Street 1:456 W. FRONTAGE RD. SUITE 32
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093
Practice Address - Country:US
Practice Address - Phone:773-610-3766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical