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General NPI Number Information
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NPI Number | 1801442678
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Entity Type | Organization
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Legal Business Name | BENEDICT PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 155 N MICHIGAN AVE STE 758
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City | CHICAGO
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State | IL
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Zip | 60601-7711
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Country | US
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Telephone | 872-256-1418
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Fax |
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Provider Business Mailing Address
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Address Line | 155 N MICHIGAN AVE STE 758
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City | CHICAGO
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State | IL
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Zip | 60601-7711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. STEPHANIE BENEDICT
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Credential | PSY.D.
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Telephone | 773-771-2970
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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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