Provider Demographics
NPI:1629179759
Name:WRIGHT, VIRGINIA CAROL (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:CAROL
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 224-A
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1444
Mailing Address - Country:US
Mailing Address - Phone:847-299-3628
Mailing Address - Fax:847-236-9115
Practice Address - Street 1:1580 N NORTHWEST HWY
Practice Address - Street 2:SUITE 224-A
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1444
Practice Address - Country:US
Practice Address - Phone:847-299-3628
Practice Address - Fax:847-236-9115
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01619534OtherBCBS PROVIDER NUMBER
IL74472306OtherAM. PSYCHOLOGICAL ASSN