Provider Demographics
NPI:1720359532
Name:PALUSKA, ASHLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:PALUSKA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 N FARNSWORTH AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1523
Mailing Address - Country:US
Mailing Address - Phone:630-851-6100
Mailing Address - Fax:630-851-6154
Practice Address - Street 1:1700 N FARNSWORTH AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1523
Practice Address - Country:US
Practice Address - Phone:630-851-6100
Practice Address - Fax:630-851-6154
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202587103TC0700X
IL071008323103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400229302Medicare PIN