Provider Demographics
NPI:1245459395
Name:ASSOCIATES IN BEHAVIORAL SCIENCE, LTD.
Entity type:Organization
Organization Name:ASSOCIATES IN BEHAVIORAL SCIENCE, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEJOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-788-8808
Mailing Address - Street 1:6201 WEST CERMAK
Mailing Address - Street 2:2ND FLOOR - LOMBARD ENTRANCE
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-5105
Mailing Address - Country:US
Mailing Address - Phone:708-788-8808
Mailing Address - Fax:708-788-8549
Practice Address - Street 1:6201 WEST CERMAK
Practice Address - Street 2:2ND FLOOR, LOMBARD ENTRANCE
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-5101
Practice Address - Country:US
Practice Address - Phone:708-788-8808
Practice Address - Fax:708-788-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003731103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL924490Medicare PIN