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General NPI Number Information
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NPI Number | 1730933896
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Entity Type | Individual
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Provider Name | OANA DEMIAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 175 OLDE HALF DAY RD
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3061
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Country | US
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Telephone | 847-242-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 3040 HARRISON ST
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City | GLENVIEW
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State | IL
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Zip | 60025-4674
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Country | US
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Telephone | 312-722-2330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 071011199
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License Number State | IL
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