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NPI 1558299313

NPI 1558299313 : PAULA CORMALLETH, LLC : LINCOLNWOOD, IL

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General NPI Number Information
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    NPI Number           |    1558299313
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAULA CORMALLETH, LLC 
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Dates
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    Enumeration Date     |    05/12/2026
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    Last Update Date     |    05/12/2026
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Provider Practice Location Address
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    Address Line         |    6705 N KEDVALE AVE 
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    City                 |    LINCOLNWOOD
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    State                |    IL
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    Zip                  |    60712-3511
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    Country              |    US
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    Telephone            |    847-863-7697
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6705 N KEDVALE AVE 
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    City                 |    LINCOLNWOOD
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    State                |    IL
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    Zip                  |    60712-3511
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    Country              |    US
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    Telephone            |    847-863-7697
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PSY.D.
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    Name                 |     PAULA  CORMALLETH 
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    Credential           |    
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    Telephone            |    847-863-7697
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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       |    
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    License Number State |    
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