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General NPI Number Information
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NPI Number | 1326219510
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Entity Type | Organization
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Legal Business Name | OAK FOREST PSYCHOLOGICAL SERVICE
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 6502 JOLIET RD
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-4682
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Country | US
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Telephone | 708-215-8400
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Fax | 708-215-8410
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Provider Business Mailing Address
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Address Line | 6502 JOLIET RD FLOOR 2
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-4613
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Country | US
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Telephone | 708-215-8400
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Fax | 708-215-8410
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | KAREN NEKOLNY-SMITH
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Credential |
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Telephone | 708-215-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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