Provider Demographics
NPI:1881886885
Name:NORTHWEST NEUROPSYCHOLOGY INCORPORATED
Entity type:Organization
Organization Name:NORTHWEST NEUROPSYCHOLOGY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:ESCHBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-240-0444
Mailing Address - Street 1:800 E WOODFIELD RD
Mailing Address - Street 2:# 103
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4718
Mailing Address - Country:US
Mailing Address - Phone:847-240-0444
Mailing Address - Fax:847-240-0446
Practice Address - Street 1:800 E WOODFIELD RD
Practice Address - Street 2:# 103
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4718
Practice Address - Country:US
Practice Address - Phone:847-240-0444
Practice Address - Fax:847-240-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty