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General NPI Number Information
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NPI Number | 1861660326
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Entity Type | Organization
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Legal Business Name | RAUSER PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 4037 N SHERIDAN RD UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60613-5218
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Country | US
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Telephone | 773-301-6144
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Fax |
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Provider Business Mailing Address
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Address Line | 4037 N SHERIDAN RD UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60613-5218
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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 | PRESIDENT
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Name | DR. MARK RAUSER
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Credential | PSY.D.
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Telephone | 773-301-6144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State | IL
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