Healthcare Provider Details

I. General information

NPI: 1205882313
Provider Name (Legal Business Name): NEUROPSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 N ARLINGTON HEIGHTS RD SUITE K
ARLINGTON HEIGHTS IL
60004-7701
US

IV. Provider business mailing address

3375 N ARLINGTON HEIGHTS RD SUITE K
ARLINGTON HEIGHTS IL
60004-7701
US

V. Phone/Fax

Practice location:
  • Phone: 847-394-4174
  • Fax: 847-394-4176
Mailing address:
  • Phone: 847-394-4174
  • Fax: 847-394-4176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERICK WILBURN BYLSMA
Title or Position: OWNER, PRESIDENT
Credential: PH.D.
Phone: 847-738-4528