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General NPI Number Information
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NPI Number | 1437535366
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Entity Type | Organization
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Legal Business Name | THE RELATIONSHIP INSTITUTE
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 222 MERCHANDISE MART PLZ SUITE 4112
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City | CHICAGO
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State | IL
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Zip | 60654-1103
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Country | US
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Telephone | 773-759-8061
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Fax |
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Provider Business Mailing Address
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Address Line | 6351 W MONTROSE AVE UNIT 153
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City | CHICAGO
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State | IL
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Zip | 60634-1563
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Country | US
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Telephone | 773-759-8061
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. THERESA A SEGURA-HERRERA
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Credential | PHD
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Telephone | 773-759-8061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071008568
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License Number State | IL
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