Provider Demographics
NPI:1689832693
Name:PFILE, NORMAN H
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:H
Last Name:PFILE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 ELAINE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2435
Mailing Address - Country:US
Mailing Address - Phone:815-397-7654
Mailing Address - Fax:815-397-2712
Practice Address - Street 1:5804 ELAINE DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108
Practice Address - Country:US
Practice Address - Phone:815-397-7654
Practice Address - Fax:815-397-2712
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149002520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149002520OtherILLINOIS LICENSE