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General NPI Number Information
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NPI Number | 1720778608
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Entity Type | Organization
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Legal Business Name | KARIN M. NUSSBAUM, PH.D., PLLC
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE STE 1820
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City | CHICAGO
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State | IL
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Zip | 60601-7415
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Country | US
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Telephone | 773-559-2245
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Fax |
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Provider Business Mailing Address
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Address Line | 2433 CENTER AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062-4452
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Country | US
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Telephone | 773-263-0938
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KARIN NUSSBAUM
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Credential |
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Telephone | 773-559-2245
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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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