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General NPI Number Information
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NPI Number | 1447472493
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Entity Type | Organization
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Legal Business Name | RICHARD P WEBER PSY.D.
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1105 W PARK AVE SUITE 2
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2567
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Country | US
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Telephone | 847-362-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 W PARK AVE SUITE 2
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2567
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Country | US
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Telephone | 847-362-5601
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | RICHARD PHILLIP WEBER
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Credential | PSY.D
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Telephone | 847-362-5601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State | IL
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