Provider Demographics
NPI:1851617807
Name:ATCHLEY, THERESA K
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:K
Last Name:ATCHLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2228
Mailing Address - Country:US
Mailing Address - Phone:708-602-9215
Mailing Address - Fax:
Practice Address - Street 1:530 N ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2228
Practice Address - Country:US
Practice Address - Phone:708-602-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health