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General NPI Number Information
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NPI Number | 1770909673
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Entity Type | Individual
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Provider Name | EDDIE TAYLOR PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2014
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Last Update Date | 02/28/2026
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Provider Practice Location Address
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Address Line | 205 N MICHIGAN AVE STE 810
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City | CHICAGO
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State | IL
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Zip | 60601-5902
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Country | US
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Telephone | 312-405-0143
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Fax | 855-515-9479
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Provider Business Mailing Address
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Address Line | 205 N MICHIGAN AVE STE 810
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City | CHICAGO
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State | IL
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Zip | 60601-5902
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Country | US
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Telephone | 480-865-9753
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Fax | 855-515-9479
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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 | PSY-004891
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20042750A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 39638
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.009281
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License Number State | IL
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