Healthcare Provider Details

I. General information

NPI: 1003018268
Provider Name (Legal Business Name): PAMELA DALEY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE STE 1022
CHICAGO IL
60602-3758
US

IV. Provider business mailing address

225 S RIDGELAND AVE
OAK PARK IL
60302-3225
US

V. Phone/Fax

Practice location:
  • Phone: 773-615-9477
  • Fax:
Mailing address:
  • Phone: 773-615-9477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071-006720
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: