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General NPI Number Information
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NPI Number | 1649490517
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Entity Type | Organization
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Legal Business Name | NORTH SUBURBAN FAMILY PSYCHOLOGISTS
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 4433 W TOUHY AVE SUITE 500
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1820
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Country | US
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Telephone | 847-568-9642
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Fax | 847-568-1242
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Provider Business Mailing Address
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Address Line | 4433 W TOUHY AVE SUITE 500
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1820
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Country | US
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Telephone | 847-568-9642
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Fax | 847-568-1242
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CARLA M LEONE
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Credential | PH.D.
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Telephone | 847-568-9642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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