Healthcare Provider Details

I. General information

NPI: 1710156286
Provider Name (Legal Business Name): PERFORMANCE ENHANCEMENT INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HOBSON RD STE 232
NAPERVILLE IL
60540-8138
US

IV. Provider business mailing address

1220 HOBSON RD STE 232
NAPERVILLE IL
60540-8138
US

V. Phone/Fax

Practice location:
  • Phone: 630-637-4002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071003188
License Number StateIL

VIII. Authorized Official

Name: DAVID E DREHMER
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 630-637-4002