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General NPI Number Information
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NPI Number | 1811178163
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN ADOLESCENT PSYCHIATRY SC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 530 LINCOLN AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1420
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Country | US
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Telephone | 630-290-8461
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Fax | 847-835-0863
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Provider Business Mailing Address
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Address Line | 530 LINCOLN AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1420
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Country | US
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Telephone | 630-290-8461
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Fax | 847-835-0863
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARVIN J SCHWARZ
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Credential | M.D.
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Telephone | 630-290-8461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State | IL
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