Provider Demographics
NPI:1477861250
Name:PARET, ALEXANDER J (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:J
Last Name:PARET
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 1:801 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4005
Mailing Address - Country:US
Mailing Address - Phone:847-904-2299
Mailing Address - Fax:847-834-0087
Practice Address - Street 1:5250 OLD ORCHARD RD
Practice Address - Street 2:STE 300
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4460
Practice Address - Country:US
Practice Address - Phone:847-904-2299
Practice Address - Fax:847-834-0087
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1139103T00000X
IL071008152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical