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General NPI Number Information
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NPI Number | 1235847591
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Entity Type | Individual
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Provider Name | RODRIGO SEBASTIAN TORRES PHD, MA
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Gender | Male
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE STE 1830
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City | CHICAGO
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State | IL
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Zip | 60601-7407
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Country | US
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Telephone | 312-379-9476
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Fax | 312-263-1933
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Provider Business Mailing Address
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Address Line | 221 E CULLERTON ST APT 925
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City | CHICAGO
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State | IL
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Zip | 60616-1493
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Country | US
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Telephone | 312-925-2226
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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 | 071010856
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License Number State | IL
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