Healthcare Provider Details

I. General information

NPI: 1790954998
Provider Name (Legal Business Name): PERLMAN DAVIS AND ASSOCIATES IN PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 HALF DAY RD SUITE 145
BANNOCKBURN IL
60015-1217
US

IV. Provider business mailing address

2275 HALF DAY RD SUITE 145
BANNOCKBURN IL
60015-1217
US

V. Phone/Fax

Practice location:
  • Phone: 847-236-1574
  • Fax:
Mailing address:
  • Phone: 847-236-1574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number71-3882
License Number StateIL

VIII. Authorized Official

Name: DR. BARBARA NELSON PERLMAN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 847-236-1574