Healthcare Provider Details

I. General information

NPI: 1891329215
Provider Name (Legal Business Name): DOCTOR GETZ L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3047 N LINCOLN AVE UNIT 400
CHICAGO IL
60657-4274
US

IV. Provider business mailing address

1447 W CUYLER AVE
CHICAGO IL
60613-1917
US

V. Phone/Fax

Practice location:
  • Phone: 312-900-0913
  • Fax:
Mailing address:
  • Phone: 312-900-0913
  • Fax: 312-546-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHARON GETZ
Title or Position: CLINICAL PSYCHOLOGIST/OWNER
Credential: PSY.D.
Phone: 312-900-0913