Provider Demographics
NPI:1558100545
Name:CECILY KANTER CENTER FOR PSYCHOLOGICAL SERVICES INCORPORATE
Entity type:Organization
Organization Name:CECILY KANTER CENTER FOR PSYCHOLOGICAL SERVICES INCORPORATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-525-7504
Mailing Address - Street 1:750 W LAKE COOK RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-2093
Mailing Address - Country:US
Mailing Address - Phone:847-814-5031
Mailing Address - Fax:847-259-8891
Practice Address - Street 1:750 W LAKE COOK RD STE 105
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-2093
Practice Address - Country:US
Practice Address - Phone:847-814-5031
Practice Address - Fax:847-259-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty