Provider Demographics
NPI:1417099540
Name:RICE-ERSO, HAROLD MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:MARTIN
Last Name:RICE-ERSO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 REMINGTON RD
Mailing Address - Street 2:SUITE M
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4831
Mailing Address - Country:US
Mailing Address - Phone:847-882-0445
Mailing Address - Fax:
Practice Address - Street 1:1350 REMINGTON RD
Practice Address - Street 2:SUITE M
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4831
Practice Address - Country:US
Practice Address - Phone:847-882-0445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical