Healthcare Provider Details

I. General information

NPI: 1417795428
Provider Name (Legal Business Name): ARROYO PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 W LAKE ST STE 2S
CHICAGO IL
60661-1034
US

IV. Provider business mailing address

7633 N GREENVIEW AVE APT 3E
CHICAGO IL
60626-1293
US

V. Phone/Fax

Practice location:
  • Phone: 312-767-8238
  • Fax: 312-334-3762
Mailing address:
  • Phone: 312-767-8238
  • Fax: 312-334-3762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE ARROYO
Title or Position: MANAGER
Credential: PHD
Phone: 312-767-8238