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General NPI Number Information
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NPI Number | 1346361961
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Entity Type | Organization
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Legal Business Name | ALEXIS LYBROOK TAUBERT, PH.D, LTD.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1305 S MICHIGAN AVE APT 1309
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City | CHICAGO
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State | IL
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Zip | 60605-3402
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Country | US
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Telephone | 773-227-7597
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 S MICHIGAN AVE APT 1309
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City | CHICAGO
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State | IL
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Zip | 60605-3402
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Country | US
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Telephone | 773-227-7597
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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. ALEXIS LYBROOK TAUBERT
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Credential | PH.D.
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Telephone | 773-248-4544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 060-007678
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License Number State | IL
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Taxonomy #2
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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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