Healthcare Provider Details

I. General information

NPI: 1447286661
Provider Name (Legal Business Name): DIAGNOSTIC AND DEVELOPMENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 LAKE COOK RD SUITE 206
NORTHBROOK IL
60062-1447
US

IV. Provider business mailing address

1535 LAKE COOK RD SUITE 206
NORTHBROOK IL
60062-1447
US

V. Phone/Fax

Practice location:
  • Phone: 847-480-7880
  • Fax: 847-480-7884
Mailing address:
  • Phone: 847-480-7880
  • Fax: 847-480-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. RICHARD C SAUL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-480-7880