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General NPI Number Information
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NPI Number | 1013781947
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Entity Type | Organization
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Legal Business Name | CHERYL A OTOOLE PLLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 5349 N WINTHROP AVE
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City | CHICAGO
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State | IL
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Zip | 60640-2309
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Country | US
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Telephone | 312-339-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 5443 N GLENWOOD AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60640-0604
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Country | US
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Telephone | 312-339-6180
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. CHERYL ANNE O'TOOLE
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Credential | PSYD
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Telephone | 312-339-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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