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General NPI Number Information
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NPI Number | 1164936043
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Entity Type | Organization
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Legal Business Name | ANNA M ADAMS PSYD CENTER FOR SOCIAL EMOTIONAL WELLNESS LTD
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 355 W DUNDEE RD STE 200
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-3500
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Country | US
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Telephone | 630-882-0344
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Fax |
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Provider Business Mailing Address
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Address Line | 355 W DUNDEE RD STE 200
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-3500
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Country | US
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Telephone | 630-882-0344
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | ANNA M ADAMS
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Credential | PSYD
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Telephone | 630-882-0344
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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 | 071008577
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License Number State | IL
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