Provider Demographics
NPI:1982762738
Name:JOSEPH J NOVAK PC
Entity Type:Organization
Organization Name:JOSEPH J NOVAK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-308-4750
Mailing Address - Street 1:415 EAST GOLF ROAD
Mailing Address - Street 2:#115
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4049
Mailing Address - Country:US
Mailing Address - Phone:847-308-4750
Mailing Address - Fax:847-981-0878
Practice Address - Street 1:415 EAST GOLF ROAD
Practice Address - Street 2:#115
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4049
Practice Address - Country:US
Practice Address - Phone:847-308-4750
Practice Address - Fax:847-981-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty