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General NPI Number Information
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NPI Number | 1609927045
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Entity Type | Organization
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Legal Business Name | DENISE LEGACKI TOMPKINS, PSY.D. & ASSOC. LTD.
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 1801 N MILL ST SUITE C
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City | NAPERVILLE
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State | IL
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Zip | 60563-1274
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Country | US
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Telephone | 630-717-5911
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Fax | 630-717-9140
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Provider Business Mailing Address
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Address Line | 1801 N MILL ST SUITE C
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City | NAPERVILLE
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State | IL
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Zip | 60563-1274
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Country | US
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Telephone | 630-717-5911
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Fax | 630-717-9140
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. DENISE LEGACKI TOMPKINS
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Credential | PSY.D.
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Telephone | 630-717-5911
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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 | 71006304
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License Number State | IL
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