Provider Demographics
NPI:1689275265
Name:SUSAN BENJAMIN FEINGOLD PSYD AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:SUSAN BENJAMIN FEINGOLD PSYD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUAGENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-480-5186
Mailing Address - Street 1:1038 N CROSBY ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2404
Mailing Address - Country:US
Mailing Address - Phone:847-831-7731
Mailing Address - Fax:
Practice Address - Street 1:1038 N CROSBY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2404
Practice Address - Country:US
Practice Address - Phone:847-831-7731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty