Provider Demographics
NPI:1932193455
Name:NEURO-PSYCH TECHNOLOGIES, LTD.
Entity Type:Organization
Organization Name:NEURO-PSYCH TECHNOLOGIES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BAWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-446-7911
Mailing Address - Street 1:PO BOX 8159
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-8159
Mailing Address - Country:US
Mailing Address - Phone:847-446-7911
Mailing Address - Fax:847-386-6239
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:847-446-7911
Practice Address - Fax:847-386-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-0035702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL260039385OtherRAIL ROAD RETIREMENT
IL2160834332OtherBLUE CROSS NUMBER
IL260039385OtherRAIL ROAD RETIREMENT
IL=========-60048-01Medicaid
IL=========-60048-01Medicaid