Healthcare Provider Details

I. General information

NPI: 1437216363
Provider Name (Legal Business Name): LARRY D TURNER PSY.D., RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 S EUCLID AVE
CHICAGO IL
60649-2934
US

IV. Provider business mailing address

7235 S EUCLID AVE
CHICAGO IL
60649-2934
US

V. Phone/Fax

Practice location:
  • Phone: 773-324-6072
  • Fax: 773-324-6072
Mailing address:
  • Phone: 773-324-6072
  • Fax: 773-324-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberIL01209
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number41195047
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-007464
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: