Healthcare Provider Details

I. General information

NPI: 1013985241
Provider Name (Legal Business Name): CAROLYN F. ANDREWS PH. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 6TH ST STE A NAVAL HEALTH CLINIC, BLDG 200-H 9-N MENTAL HEALTH CNTR
GREAT LAKES IL
60088-2833
US

IV. Provider business mailing address

3001 6TH ST STE A NAVAL HEALTH CLINIC, BLDG 200-H 9-N MENTAL HEALTH CNTR
GREAT LAKES IL
60088-2833
US

V. Phone/Fax

Practice location:
  • Phone: 847-688-2221
  • Fax: 847-688-2697
Mailing address:
  • Phone: 847-688-2221
  • Fax: 847-688-2697

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: