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NPI Code Detail

MEDICARE: CHELSEY HALL ED.S. NCSP

MEDICARE: CHELSEY HALL ED.S. NCSP
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
1103TS0200XSchool Psychologist
2103TS0200XSchool Psychologist988360IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1988360OTHERILISBE

General Provider Information

NPI Number : 1558887976
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEY HALL ED.S. NCSP
Provider Business Mailing Address
First Line : 42 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4309
Country : US
Telephone Number : 773-553-1000
Fax Number :
Provider Business Practice Location Address
First Line : 42 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4309
Country : US
Telephone Number : 773-553-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2017
Last Update Date : 10/25/2023

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