Healthcare Provider Details

I. General information

NPI: 1548339955
Provider Name (Legal Business Name): STEVEN E HURLEY PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVE HURLEY PSY.D.

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOLLISTER DR
LIBERTYVILLE IL
60048-5263
US

IV. Provider business mailing address

756 DALTON LN
BOLINGBROOK IL
60490-3214
US

V. Phone/Fax

Practice location:
  • Phone: 847-636-3610
  • Fax: 847-932-4066
Mailing address:
  • Phone: 630-885-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071007009
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: