Provider Demographics
NPI:1457786006
Name:ALHOCH, TAYEBA S (PSYD)
Entity Type:Individual
Prefix:
First Name:TAYEBA
Middle Name:S
Last Name:ALHOCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:TAYEBA
Other - Middle Name:
Other - Last Name:SHAIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:111 N WABASH AVE STE 1003
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-999-7114
Mailing Address - Fax:
Practice Address - Street 1:111 N WABASH AVE STE 1003
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-999-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00595400103T00000X
MI6301015511103TC0700X
NY022111103TC0700X
IL071010165103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0710101165OtherLICENSE NUMBER
NY022111OtherLICENSE NUMBER
MI6301015511OtherLICENSE NUMBER