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General NPI Number Information
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NPI Number | 1568988905
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 315 N DRYDEN PL
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-6313
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Country | US
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Telephone | 847-436-8511
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Fax | 847-873-0206
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Provider Business Mailing Address
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Address Line | 315 N DRYDEN PL
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-6313
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Country | US
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Telephone | 847-436-8511
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Fax | 847-873-0206
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | DR. JENNIFER L WILSON-BINOTTI
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Credential | PSYD
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Telephone | 847-436-8511
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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 | 071008512
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License Number State | IL
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