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General NPI Number Information
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NPI Number | 1063576478
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Entity Type | Organization
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Legal Business Name | PSYCHOSOCIAL INTERVENTIONS, P.C.
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 977 LAKEVIEW PKWY SUITE 1008
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City | VERNON HILLS
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State | IL
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Zip | 60061-1400
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Country | US
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Telephone | 312-618-1921
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Fax | 847-816-8881
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Provider Business Mailing Address
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Address Line | 977 LAKEVIEW PKWY SUITE 1008
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City | VERNON HILLS
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State | IL
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Zip | 60061-1400
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Country | US
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Telephone | 312-618-1921
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Fax | 847-816-8881
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. RONALD HENRY ROSENTHAL
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Credential | PH.D.
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Telephone | 312-618-1921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State | IL
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