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General NPI Number Information
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NPI Number | 1235240896
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Entity Type | Individual
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Provider Name | ANNE M. NATHAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 175 OLDE HALF DAY ROAD
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069
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Country | US
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Telephone | 847-777-6922
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Fax | 847-777-6923
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Provider Business Mailing Address
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Address Line | 175 OLDE HALF DAY ROAD
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069
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Country | US
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Telephone | 847-777-6922
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Fax | 847-777-6923
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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 | PS007663L
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License Number State | PA
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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 | 35S100382800
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License Number State | NJ
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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 | 071.007361
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 355100382800
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License Number State | NJ
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