Provider Demographics
NPI:1467505503
Name:ROBERT A. WATSON, PSY.D., L.L.C.
Entity Type:Organization
Organization Name:ROBERT A. WATSON, PSY.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-275-7706
Mailing Address - Street 1:3100 W HIGGINS RD
Mailing Address - Street 2:SUITE 195
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-5251
Mailing Address - Country:US
Mailing Address - Phone:847-275-7706
Mailing Address - Fax:847-310-8600
Practice Address - Street 1:3100 W HIGGINS RD
Practice Address - Street 2:SUITE 195
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-5251
Practice Address - Country:US
Practice Address - Phone:847-275-7706
Practice Address - Fax:847-310-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71004730103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty