Provider Demographics
NPI:1770850083
Name:ALM, THOMAS GEORGE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GEORGE
Last Name:ALM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3047 N LINCOLN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4999
Mailing Address - Country:US
Mailing Address - Phone:773-494-5505
Mailing Address - Fax:
Practice Address - Street 1:3047 N LINCOLN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4999
Practice Address - Country:US
Practice Address - Phone:773-494-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008234103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical