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General NPI Number Information
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NPI Number | 1316122963
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Entity Type | Organization
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Legal Business Name | HELLER PSYCHOLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1 E SUPERIOR ST 310
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City | CHICAGO
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State | IL
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Zip | 60611-2507
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Country | US
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Telephone | 312-988-7792
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Fax | 312-988-4040
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Provider Business Mailing Address
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Address Line | 1 E SUPERIOR ST STE 506
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City | CHICAGO
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State | IL
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Zip | 60611-2593
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Country | US
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Telephone | 847-410-9059
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Fax | 312-988-4040
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA GERBER
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Credential | PSYD
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Telephone | 847-410-9059
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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 | 071002999
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License Number State | IL
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