Provider Demographics
NPI:1568728061
Name:PHILIP J METRES JR, PH.D.,P.C.
Entity Type:Organization
Organization Name:PHILIP J METRES JR, PH.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:METRES
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-498-3623
Mailing Address - Street 1:175 OLDE HALF DAY RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3063
Mailing Address - Country:US
Mailing Address - Phone:847-498-3623
Mailing Address - Fax:
Practice Address - Street 1:175 OLD HLF DAY RD STE 205175
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3061
Practice Address - Country:US
Practice Address - Phone:847-498-3623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-0002256103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty