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General NPI Number Information
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NPI Number | 1619360872
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Entity Type | Individual
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Provider Name | ANTHONY CARL REDMOND PSYD. M.A., CAADC
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Gender | Male
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 1609 SIBLEY BLVD
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City | CALUMET CITY
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State | IL
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Zip | 60409-2217
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Country | US
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Telephone | 708-716-0534
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Fax | 708-841-5686
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Provider Business Mailing Address
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Address Line | 1609 SIBLEY BLVD
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City | CALUMET CITY
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State | IL
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Zip | 60409-2217
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Country | US
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Telephone | 708-716-0534
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Fax | 708-841-5686
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 178.009745
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License Number State | IL
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