Healthcare Provider Details

I. General information

NPI: 1881886885
Provider Name (Legal Business Name): NORTHWEST NEUROPSYCHOLOGY INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E WOODFIELD RD # 103
SCHAUMBURG IL
60173-4718
US

IV. Provider business mailing address

800 E WOODFIELD RD # 103
SCHAUMBURG IL
60173-4718
US

V. Phone/Fax

Practice location:
  • Phone: 847-240-0444
  • Fax: 847-240-0446
Mailing address:
  • Phone: 847-240-0444
  • Fax: 847-240-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ALEXANDER ADAM ESCHBACH
Title or Position: CLINICAL PSYCHOLOGIST/PRESIDENT
Credential: PH.D.
Phone: 847-240-0444