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General NPI Number Information
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NPI Number | 1164062782
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Entity Type | Individual
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Provider Name | ALEV G ILDIZ PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2020
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE STE 1909
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City | CHICAGO
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State | IL
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Zip | 60601-7401
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Country | US
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Telephone | 773-425-2063
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E ERIE ST STE 525-5175
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City | CHICAGO
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State | IL
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Zip | 60611-2740
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Country | US
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Telephone | 773-425-2063
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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 | PY10320
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4065-57
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010024
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License Number State | IL
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