Provider Demographics
NPI:1457658700
Name:AIM PSYCHOLOGICAL SERVICES CORP
Entity Type:Organization
Organization Name:AIM PSYCHOLOGICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-802-1956
Mailing Address - Street 1:13 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6483
Mailing Address - Country:US
Mailing Address - Phone:312-802-1956
Mailing Address - Fax:815-730-1147
Practice Address - Street 1:13 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6483
Practice Address - Country:US
Practice Address - Phone:312-802-1956
Practice Address - Fax:815-730-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL653160OtherMEDICARE ID TYPE UNSPECIFIED PART B