Provider Demographics
NPI:1598845422
Name:NEALON WOODS, MICHELE ANTOINETTE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANTOINETTE
Last Name:NEALON WOODS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:ANTOINETTE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:PALOS BEHAVIORAL HEALTH PROFESSIONALS
Mailing Address - Street 2:103011 S 104TH AVE SUITE 200
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464
Mailing Address - Country:US
Mailing Address - Phone:708-448-3300
Mailing Address - Fax:708-448-6772
Practice Address - Street 1:PALOS BEHAVIORAL HEALTH PROFESSIONALS
Practice Address - Street 2:103011 S 104TH AVE SUITE 200
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464
Practice Address - Country:US
Practice Address - Phone:708-448-3300
Practice Address - Fax:708-448-6772
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist