Provider Demographics
NPI:1629257829
Name:CLOCKTOWER PSYCHOLOGICAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:CLOCKTOWER PSYCHOLOGICAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-726-2400
Mailing Address - Street 1:1 GOLFVIEW RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1210
Mailing Address - Country:US
Mailing Address - Phone:847-726-2400
Mailing Address - Fax:
Practice Address - Street 1:1 GOLFVIEW RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-1210
Practice Address - Country:US
Practice Address - Phone:847-726-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004840103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty