Provider Demographics
NPI:1568609105
Name:DIANA BELIARD, PH.D.; P.C.
Entity Type:Organization
Organization Name:DIANA BELIARD, PH.D.; P.C.
Other - Org Name:DIANA BELIARD, PH.D.; P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELIARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-328-9566
Mailing Address - Street 1:2530 CRAWFORD AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4970
Mailing Address - Country:US
Mailing Address - Phone:847-328-9566
Mailing Address - Fax:847-784-5052
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-328-9566
Practice Address - Fax:847-784-5052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIANA BELIARD, PH.D.; P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health