Provider Demographics
NPI:1689724460
Name:ASSOCIATED PSYCHOLOGISTS
Entity Type:Organization
Organization Name:ASSOCIATED PSYCHOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAP
Authorized Official - Middle Name:
Authorized Official - Last Name:POZULP
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:312-339-3708
Mailing Address - Street 1:77 W WASHINGTON ST
Mailing Address - Street 2:SUITE 1519
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2801
Mailing Address - Country:US
Mailing Address - Phone:312-630-1001
Mailing Address - Fax:312-630-1342
Practice Address - Street 1:77 W WASHINGTON ST
Practice Address - Street 2:SUITE 1519
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2801
Practice Address - Country:US
Practice Address - Phone:312-630-1001
Practice Address - Fax:312-630-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617085OtherBC BS PROVIDER ID
IL1617085OtherBC BS PROVIDER ID