Provider Demographics
NPI:1629126750
Name:FRANCIS, PATRICIA ROSE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ROSE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 THORNHILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2706
Mailing Address - Country:US
Mailing Address - Phone:630-752-9750
Mailing Address - Fax:630-752-9768
Practice Address - Street 1:507 THORNHILL DR STE A
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2706
Practice Address - Country:US
Practice Address - Phone:630-752-9750
Practice Address - Fax:630-752-9768
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.006372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR01171OtherMEDICARE CMS