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General NPI Number Information
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NPI Number | 1306020144
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Entity Type | Organization
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Legal Business Name | MARY H. CASE, PH.D. P.C.
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 625 N MICHIGAN AVE 1750
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City | CHICAGO
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State | IL
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Zip | 60611-3110
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Country | US
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Telephone | 312-203-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 625 N MICHIGAN AVE 1750
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City | CHICAGO
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State | IL
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Zip | 60611-3110
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Country | US
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Telephone | 312-203-8114
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY H. CASE
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Credential | PH.D.
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Telephone | 312-203-8114
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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 | 180004710
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License Number State | IL
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