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NPI Code Detail

MEDICARE: MICHAEL PALUMBO PHD

MEDICARE: MICHAEL PALUMBO PHD
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 Psychologist071.010919IL

General Provider Information

NPI Number : 1689209876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PALUMBO PHD
Provider Business Mailing Address
First Line : 5315 N CLARK ST # 181
Second Line :
City : CHICAGO
State : IL
Zip : 60640-2290
Country : US
Telephone Number : 872-272-7575
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 : 872-272-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2020
Last Update Date : 01/01/2025

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