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General NPI Number Information
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NPI Number | 1508062761
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Entity Type | Individual
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Provider Name | TRICIA A MCKINNEY PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 2030 E ALGONQUIN RD SUITE 401
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City | SCHAUMBURG
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State | IL
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Zip | 60173-4188
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Country | US
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Telephone | 847-791-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 1722 N WATERMAN AVE
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-4252
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Country | US
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Telephone | 847-791-2851
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 071.007795
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License Number State | IL
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