Healthcare Provider Details

I. General information

NPI: 1245417369
Provider Name (Legal Business Name): VERNE H. NOPARSTAK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
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 APT 3
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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number071005397
License Number StateIL

VIII. Authorized Official

Name: DR. VERNE HOWARD NOPARSTAK
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 847-404-1312