Provider Demographics
NPI:1417252644
Name:DEGOOD, SALOUMEH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SALOUMEH
Middle Name:
Last Name:DEGOOD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SALOUMEH
Other - Middle Name:
Other - Last Name:BOZORGZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2845 N SHERIDAN RD
Mailing Address - Street 2:STE 708
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2845 N SHERIDAN RD
Practice Address - Street 2:STE 708
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-906-3225
Practice Address - Fax:773-906-3270
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007717101YM0800X
IL071008615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health