Provider Demographics
NPI:1952562670
Name:MARKOWITZ, PAULA RUTH (PSYD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:RUTH
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 WEST GEORGE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4086
Mailing Address - Country:US
Mailing Address - Phone:312-456-0012
Mailing Address - Fax:
Practice Address - Street 1:8 SOUTH MICHIGAN
Practice Address - Street 2:SUITE 1500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603
Practice Address - Country:US
Practice Address - Phone:312-456-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004473103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical