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General NPI Number Information
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NPI Number | 1629391065
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Entity Type | Individual
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Provider Name | SWATI PITALE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 53 W JACKSON BLVD SUITE 602
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City | CHICAGO
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State | IL
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Zip | 60604-3606
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Country | US
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Telephone | 773-961-5405
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 N SHEFFIELD AVE SUITE 350
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City | CHICAGO
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State | IL
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Zip | 60614-3673
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Country | US
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Telephone | 773-961-5405
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071-007537
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License Number State | IL
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