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NPI Code Detail

MEDICARE: RESILIENCE PSYCHOLOGICAL SERVICES, PC

MEDICARE: RESILIENCE PSYCHOLOGICAL SERVICES, PC
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1629443536
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESILIENCE PSYCHOLOGICAL SERVICES, PC
Provider Business Mailing Address
First Line : 303 E WACKER DR STE 1130
Second Line :
City : CHICAGO
State : IL
Zip : 60601-5227
Country : US
Telephone Number : 312-600-3935
Fax Number :
Provider Business Practice Location Address
First Line : 303 E WACKER DR STE 1130
Second Line :
City : CHICAGO
State : IL
Zip : 60601-5227
Country : US
Telephone Number : 708-567-4950
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RYAN DUMP
Credential : PSYD
Telephone Number : 312-600-3935
Provider Enumeration Date : 12/03/2015
Last Update Date : 07/08/2024

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