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General NPI Number Information
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NPI Number | 1033570296
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE SUITE 515
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-878-8585
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Fax | 317-878-8585
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Provider Business Mailing Address
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Address Line | 655 W IRVING PARK RD SUITE 201
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City | CHICAGO
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State | IL
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Zip | 60613-3123
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Country | US
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Telephone | 312-878-8585
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Fax | 312-878-8585
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL E. BRICKER
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Credential | PHD
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Telephone | 773-428-0159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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