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General NPI Number Information
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NPI Number | 1558854372
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Entity Type | Organization
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Legal Business Name | FATMA AYDIN PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 325 N WELLS ST STE 328
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City | CHICAGO
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State | IL
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Zip | 60654-7023
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Country | US
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Telephone | 312-399-2945
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 N SHERIDAN RD APT 603
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City | CHICAGO
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State | IL
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Zip | 60640-7335
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Country | US
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Telephone | 708-669-6059
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. FATMA AYDIN
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Credential | PHD
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Telephone | 312-399-2945
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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 | 071009634
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License Number State | IL
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