Healthcare Provider Details

I. General information

NPI: 1306221338
Provider Name (Legal Business Name): ALICIA ALI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 W KOLMAR AVE
CHICAGO IL
60641
US

IV. Provider business mailing address

917 W WASHINGTON BLVD # 272
CHICAGO IL
60607-2203
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-3655
  • Fax:
Mailing address:
  • Phone: 312-248-3655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071009851
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: