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General NPI Number Information
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NPI Number | 1285297069
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Entity Type | Organization
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Legal Business Name | NORTHWEST SUBURBAN PSYCHOLOGY, LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 1020 MILWAUKEE AVE
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City | DEERFIELD
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State | IL
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Zip | 60015-3513
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Country | US
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Telephone | 773-326-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 MILWAUKEE AVE
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City | DEERFIELD
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State | IL
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Zip | 60015-3513
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Country | US
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Telephone | 773-326-5125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA TUCHSCHERER
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Credential | PHD
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Telephone | 773-326-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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