Healthcare Provider Details

I. General information

NPI: 1578497582
Provider Name (Legal Business Name): ABIGAIL FARRELL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 DAVIS ST
EVANSTON IL
60201-3683
US

IV. Provider business mailing address

909 DAVIS ST
EVANSTON IL
60201-3683
US

V. Phone/Fax

Practice location:
  • Phone: 847-432-5464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: