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General NPI Number Information
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NPI Number | 1720204787
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE SUITE 1008
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-263-8034
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Fax | 312-263-2289
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Provider Business Mailing Address
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Address Line | 30 N MICHIGAN AVE SUITE 1008
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-263-8034
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Fax | 312-263-2289
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ROGER THOMSON
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Credential | PH.D.
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Telephone | 312-263-8034
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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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