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General NPI Number Information
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NPI Number | 1104782671
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Entity Type | Individual
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Provider Name | PETER G MYERS PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1560 SHERMAN AVE STE 400
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City | EVANSTON
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State | IL
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Zip | 60201-4803
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Country | US
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Telephone | 847-869-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 1555 SHERMAN AVE STE 122
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City | EVANSTON
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State | IL
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Zip | 60201-4421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 071.006398
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License Number State | IL
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