Provider Demographics
NPI:1265990014
Name:PSYCHOLOGY RESOURCES, INC.
Entity type:Organization
Organization Name:PSYCHOLOGY RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:O'GRADY,
Authorized Official - Last Name:PH.D.
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-984-0417
Mailing Address - Street 1:25 E WASHINGTON ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1868
Mailing Address - Country:US
Mailing Address - Phone:312-984-0417
Mailing Address - Fax:312-456-3036
Practice Address - Street 1:25 E WASHINGTON ST STE 1201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1868
Practice Address - Country:US
Practice Address - Phone:312-984-0417
Practice Address - Fax:312-456-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1821120031OtherNPI