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General NPI Number Information
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NPI Number | 1487175022
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE PARTNERS, LLC
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 28379 DAVIS PKWY STE 801
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City | WARRENVILLE
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State | IL
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Zip | 60555-3032
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Country | US
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Telephone | 630-393-9800
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Fax | 630-393-9800
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Provider Business Mailing Address
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Address Line | 135 S YORK ST UNIT 318
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City | ELMHURST
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State | IL
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Zip | 60126-3475
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Country | US
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Telephone | 617-835-0315
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIELLE KOBY
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Credential | PHD
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Telephone | 617-835-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 071009335
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License Number State | IL
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