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General NPI Number Information
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NPI Number | 1285102020
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Entity Type | Organization
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Legal Business Name | THOMAS M KAUFMAN PSYD
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 584 CHEROKEE RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5258
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Country | US
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Telephone | 312-636-8363
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Fax |
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Provider Business Mailing Address
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Address Line | 584 CHEROKEE RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5258
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Country | US
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Telephone | 312-636-8363
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Fax |
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Authorized Official
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Title or Position | PSY.D.
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Name | THOMAS MICAH KAUFMAN
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Credential | PSY.D.
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Telephone | 312-636-8363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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