Provider Demographics
NPI:1790954998
Name:PERLMAN DAVIS AND ASSOCIATES IN PSYCHOLOGY
Entity Type:Organization
Organization Name:PERLMAN DAVIS AND ASSOCIATES IN PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-236-1574
Mailing Address - Street 1:2275 HALF DAY RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1217
Mailing Address - Country:US
Mailing Address - Phone:847-236-1574
Mailing Address - Fax:
Practice Address - Street 1:2275 HALF DAY RD
Practice Address - Street 2:SUITE 145
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1217
Practice Address - Country:US
Practice Address - Phone:847-236-1574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71-3882103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004972072OtherBLUE CROSS BLUE SHIELD
4509988OtherAETNA
163550OtherCIGNA
4509988OtherAETNA