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General NPI Number Information
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NPI Number | 1730580358
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Entity Type | Organization
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Legal Business Name | CENTRAL DUPAGE BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 4580 WEAVER PKWY STE 204
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City | WARRENVILLE
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State | IL
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Zip | 60555-3864
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Country | US
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Telephone | 630-604-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4580 WEAVER PKWY STE 204
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City | WARRENVILLE
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State | IL
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Zip | 60555-3864
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Country | US
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Telephone | 630-604-5000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KUNAL SACHDEV
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Credential | PSY.D.
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Telephone | 630-604-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071008873
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License Number State | IL
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