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General NPI Number Information
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NPI Number | 1639274715
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Entity Type | Organization
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Legal Business Name | MARY E HALPIN PHD PC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 420 LAKE COOK RD SUITE 109
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City | DEERFIELD
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State | IL
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Zip | 60015-5646
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Country | US
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Telephone | 847-317-1133
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 387
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City | ADDISON
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State | IL
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Zip | 60101-0387
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Country | US
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Telephone | 847-317-1133
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY E HALPIN
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Credential | PHD
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Telephone | 847-317-1133
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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 |
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License Number State | IL
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