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General NPI Number Information
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NPI Number | 1649931445
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Entity Type | Organization
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Legal Business Name | SRODULSKI PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 3601 ALGONQUIN RD STE 450
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-3108
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Country | US
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Telephone | 847-502-7607
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 WESLEY AVE
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City | BERWYN
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State | IL
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Zip | 60402-3136
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Country | US
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Telephone | 847-502-7607
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | ANN SRODULSKI
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Credential | PSYD
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Telephone | 847-502-7607
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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 |
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