Provider Demographics
NPI:1790021327
Name:CATHARINE DEVLIN, PSYD, SC
Entity Type:Organization
Organization Name:CATHARINE DEVLIN, PSYD, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHARINE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:DEVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-428-0959
Mailing Address - Street 1:2656 W MONTROSE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1559
Mailing Address - Country:US
Mailing Address - Phone:773-428-0959
Mailing Address - Fax:
Practice Address - Street 1:2656 W MONTROSE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1559
Practice Address - Country:US
Practice Address - Phone:773-428-0959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008442103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty