Healthcare Provider Details

I. General information

NPI: 1073012415
Provider Name (Legal Business Name): RUTH LYNN SHOOK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RUTH SHOOK-ORR PSY.D.

II. Dates (important events)

Enumeration Date: 02/11/2018
Last Update Date: 02/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 HICKS RD STE D
ROLLING MEADOWS IL
60008-1243
US

IV. Provider business mailing address

600 S CLIFTON AVE
PARK RIDGE IL
60068-4621
US

V. Phone/Fax

Practice location:
  • Phone: 847-213-9039
  • Fax:
Mailing address:
  • Phone: 847-606-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-005529
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: