Provider Demographics
NPI:1619217064
Name:DAVID HOOVER, PSYD, PC
Entity Type:Organization
Organization Name:DAVID HOOVER, PSYD, PC
Other - Org Name:CHICAGO CLINICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-436-1657
Mailing Address - Street 1:111 N WABASH AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3074
Mailing Address - Country:US
Mailing Address - Phone:312-436-1657
Mailing Address - Fax:312-284-4505
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:SUITE 822
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-436-1657
Practice Address - Fax:312-284-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007852251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health