Healthcare Provider Details

I. General information

NPI: 1134166952
Provider Name (Legal Business Name): VERNE NOPARSTAK PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 W WILSON AVE
CHICAGO IL
60640-5523
US

IV. Provider business mailing address

4521 N MAGNOLIA AVE
CHICAGO IL
60640-6245
US

V. Phone/Fax

Practice location:
  • Phone: 847-404-1312
  • Fax:
Mailing address:
  • Phone: 847-404-1312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071005397
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: