Provider Demographics
NPI:1891044152
Name:WEBER-SHIFRIN, ERYN MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERYN
Middle Name:MICHELLE
Last Name:WEBER-SHIFRIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E OHIO ST
Mailing Address - Street 2:SUITE #405
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3265
Mailing Address - Country:US
Mailing Address - Phone:312-482-9262
Mailing Address - Fax:
Practice Address - Street 1:230 E OHIO ST
Practice Address - Street 2:SUITE #405
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3265
Practice Address - Country:US
Practice Address - Phone:312-482-9262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007075103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical