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General NPI Number Information
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NPI Number | 1629997051
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Entity Type | Individual
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Provider Name | ELLEN FAY GEDDES PSYD.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 11800 S 75TH AVE FL 3
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1033
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Country | US
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Telephone | 708-726-6472
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Fax |
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Provider Business Mailing Address
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Address Line | 2736 N HAMPDEN CT APT 201
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City | CHICAGO
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State | IL
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Zip | 60614-1635
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Country | US
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Telephone | 480-980-3730
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071.022710
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License Number State | IL
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