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General NPI Number Information
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NPI Number | 1174826994
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Entity Type | Organization
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Legal Business Name | M PATRICIA FARRELL PC
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 7270 W COLLEGE DR SUITE 100
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1154
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Country | US
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Telephone | 708-361-5677
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Fax | 708-361-5390
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Provider Business Mailing Address
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Address Line | 13010 S CORNELL LN
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City | PALOS PARK
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State | IL
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Zip | 60464-2165
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Country | US
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Telephone | 708-448-3875
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Fax | 708-361-5390
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. M PATRICIA FARRELL
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Credential | PHD
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Telephone | 708-361-5677
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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 | 071.003119
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License Number State | IL
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