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General NPI Number Information
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NPI Number | 1821326117
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Entity Type | Organization
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Legal Business Name | DR DUGO AND ASSOCIATES PC
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 84 N BROADWAY ST
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City | DES PLAINES
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State | IL
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Zip | 60016-2348
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Country | US
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Telephone | 847-635-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 84 N BROADWAY ST
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City | DES PLAINES
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State | IL
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Zip | 60016-2348
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Country | US
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Telephone | 847-635-2040
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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. JAMES M DUGO
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Credential | PH. D.
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Telephone | 847-635-2040
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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 | 071-001745
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License Number State | IL
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