Provider Demographics
NPI:1023119245
Name:HOLUB, GERALDINE MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:MARIE
Last Name:HOLUB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27W291 GENEVA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-2042
Mailing Address - Country:US
Mailing Address - Phone:630-682-0645
Mailing Address - Fax:630-462-7969
Practice Address - Street 1:27W291 GENEVA RD
Practice Address - Street 2:SUITE C
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2042
Practice Address - Country:US
Practice Address - Phone:630-682-0645
Practice Address - Fax:630-462-7969
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
278617OtherVALUE OPTIONS
162842OtherCOMPSYCH
33582OtherMAGELLAN BEHAVIORAL HLTH
46369OtherCIGNA BEHAVIORAL HEALTH
6166079OtherUNITED HEALTHCARE
5574223OtherAETNA
9266056OtherPHCS PRVT HLTH CARE SERVS
V511OtherEMPIRE BCBS
33582OtherUNICARE
0002283031OtherBLUE CROSS BLUE SHIELD