Provider Demographics
NPI:1437216363
Name:TURNER, LARRY D (PSYD, RN)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:TURNER
Suffix:
Gender:M
Credentials:PSYD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7235 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-2934
Mailing Address - Country:US
Mailing Address - Phone:773-324-6072
Mailing Address - Fax:773-324-6072
Practice Address - Street 1:7235 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2934
Practice Address - Country:US
Practice Address - Phone:773-324-6072
Practice Address - Fax:773-324-6072
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL01209101YA0400X
IL41195047163WP0808X
IL071-007464103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health