Healthcare Provider Details

I. General information

NPI: 1124952569
Provider Name (Legal Business Name): ANDREW L PIPER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W GREGORY ST
MT PROSPECT IL
60056-2220
US

IV. Provider business mailing address

701 W GREGORY ST
MT PROSPECT IL
60056-2220
US

V. Phone/Fax

Practice location:
  • Phone: 847-394-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: