Healthcare Provider Details

I. General information

NPI: 1336614692
Provider Name (Legal Business Name): HOSKINS PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 11/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 RIDGE AVE STE LL4
EVANSTON IL
60201-5909
US

IV. Provider business mailing address

1740 RIDGE AVE STE LL4
EVANSTON IL
60201-5909
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-3378
  • Fax:
Mailing address:
  • Phone: 773-234-3378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OLIVIA D. HOSKINS
Title or Position: LICENSECLINICAL PSYCHOLOGIST/ OWNER
Credential: PHD
Phone: 773-234-3378