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NPI Code Detail

MEDICARE: DR. HELEN PUGACZ APPLETON PH.D.

MEDICARE: DR. HELEN PUGACZ APPLETON PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist071002838IL

General Provider Information

NPI Number : 1073557609
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HELEN PUGACZ APPLETON PH.D.
Provider Business Mailing Address
First Line : 1629 S WIGGINS AVE
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62704-3371
Country : US
Telephone Number : 217-793-3949
Fax Number : 217-793-3995
Provider Business Practice Location Address
First Line : SPRINGFIELD PSYCHOLOGICAL CENTER
Second Line : 2325 WEST WHITE OAKS DRIVE, SUITE C
City : SPRINGFIELD
State : IL
Zip : 62704-7420
Country : US
Telephone Number : 217-793-3949
Fax Number : 217-793-3995
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 05/01/2008

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