Healthcare Provider Details

I. General information

NPI: 1922497429
Provider Name (Legal Business Name): ROBIN LEIGH ZOELLER PULLMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 FOXFIELD RD STE 107
SAINT CHARLES IL
60174-1406
US

IV. Provider business mailing address

360 WEST BUTTERFIELD ROAD SUITE 340
ELMHURST IL
60177
US

V. Phone/Fax

Practice location:
  • Phone: 847-868-3435
  • Fax:
Mailing address:
  • Phone: 630-615-7807
  • Fax: 630-615-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number17867
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071006761
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.006761
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: