Healthcare Provider Details

I. General information

NPI: 1952550451
Provider Name (Legal Business Name): PSYCHOLOGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 W COLLEGE DR SUITE 205
PALOS HEIGHTS IL
60463-1152
US

IV. Provider business mailing address

7300 W COLLEGE DR SUITE 205
PALOS HEIGHTS IL
60463-1152
US

V. Phone/Fax

Practice location:
  • Phone: 708-761-3228
  • Fax: 708-761-3228
Mailing address:
  • Phone: 708-761-3228
  • Fax: 708-761-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-004207
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number071.007500
License Number StateIL

VIII. Authorized Official

Name: DR. SHARON A SAAD
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: PSY.D, LCPC
Phone: 708-761-3228