Healthcare Provider Details

I. General information

NPI: 1700828811
Provider Name (Legal Business Name): WILLIAM HOVSEPIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 N YORK RD SUITE 204
ELMHURST IL
60126-2363
US

IV. Provider business mailing address

386 N YORK RD SUITE 204
ELMHURST IL
60126-2363
US

V. Phone/Fax

Practice location:
  • Phone: 630-834-1557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: