Healthcare Provider Details

I. General information

NPI: 1154479368
Provider Name (Legal Business Name): CONSULTING PSYCHOLOGICAL SERV. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 HOHMAN AVE SUITE 1200A
MUNSTER IN
46321-1060
US

IV. Provider business mailing address

20146 S PINE HILL RD
FRANKFORT IL
60423-8372
US

V. Phone/Fax

Practice location:
  • Phone: 708-921-3827
  • Fax: 815-806-8065
Mailing address:
  • Phone: 708-921-3827
  • Fax: 815-806-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number060.007209071.002558
License Number StateIL

VIII. Authorized Official

Name: DR. DON JOSEPH FEENEY JR.
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 708-921-3827