Provider Demographics
NPI:1952078008
Name:PERCIFIELD, ABIGAIL MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:MARIE
Last Name:PERCIFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 N CLARENDON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6559
Mailing Address - Country:US
Mailing Address - Phone:219-628-1054
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1717
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1839
Practice Address - Country:US
Practice Address - Phone:219-628-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL071010934103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program