Provider Demographics
NPI:1649490517
Name:NORTH SUBURBAN FAMILY PSYCHOLOGISTS
Entity type:Organization
Organization Name:NORTH SUBURBAN FAMILY PSYCHOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-568-9642
Mailing Address - Street 1:4433 W TOUHY AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1820
Mailing Address - Country:US
Mailing Address - Phone:847-568-9642
Mailing Address - Fax:847-568-1242
Practice Address - Street 1:4433 W TOUHY AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1820
Practice Address - Country:US
Practice Address - Phone:847-568-9642
Practice Address - Fax:847-568-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty