Provider Demographics
NPI:1699860825
Name:SPENO, MARY V (PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:V
Last Name:SPENO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3285 N ARLINGTON HEIGHTS ROAD
Mailing Address - Street 2:STE 201
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004
Mailing Address - Country:US
Mailing Address - Phone:847-577-1501
Mailing Address - Fax:847-577-3858
Practice Address - Street 1:3285 N ARLINGTON HEIGHTS ROAD
Practice Address - Street 2:STE 201
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004
Practice Address - Country:US
Practice Address - Phone:847-577-1501
Practice Address - Fax:847-577-3858
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL071002989103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical