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General NPI Number Information
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NPI Number | 1376641225
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Entity Type | Individual
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Provider Name | CHRISTINE LOOK PHD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 1103 WESTGATE ST STE 200
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City | OAK PARK
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State | IL
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Zip | 60301-1022
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Country | US
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Telephone | 614-745-9536
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Fax |
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Provider Business Mailing Address
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Address Line | 424 WASHINGTON BLVD APT 3E
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City | OAK PARK
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State | IL
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Zip | 60302-4077
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Country | US
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Telephone | 614-745-9536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 071009909
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5772
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License Number State | OH
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