Provider Demographics
NPI:1770631970
Name:AMUNDSON & SCHWARTZ PSYCHOLOGICAL CONSULTING INC.
Entity Type:Organization
Organization Name:AMUNDSON & SCHWARTZ PSYCHOLOGICAL CONSULTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMUNDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-930-1833
Mailing Address - Street 1:736 N RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1736
Mailing Address - Country:US
Mailing Address - Phone:708-930-1833
Mailing Address - Fax:708-445-9730
Practice Address - Street 1:1101 LAKE ST
Practice Address - Street 2:SUITE 404
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1085
Practice Address - Country:US
Practice Address - Phone:708-930-1833
Practice Address - Fax:708-445-9730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
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 - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203882Medicare ID - Type Unspecified