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General NPI Number Information
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NPI Number | 1053595132
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Entity Type | Organization
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Legal Business Name | DAVID J. GREENBERG, PHD, LTD
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Dates
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Enumeration Date | 12/25/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 4801 W PETERSON AVE 403
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City | CHICAGO
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State | IL
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Zip | 60646-5713
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Country | US
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Telephone | 847-432-6465
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Fax | 847-432-5389
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Provider Business Mailing Address
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Address Line | 4801 W PETERSON AVE 403
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City | CHICAGO
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State | IL
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Zip | 60646-5713
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Country | US
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Telephone | 847-432-6465
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Fax | 847-432-5389
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID JOEL GREENBERG
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Credential | PHD
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Telephone | 847-432-6465
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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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