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General NPI Number Information
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NPI Number | 1881615714
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN MEDIATION & COUNSELING, INC.
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 601 SKOKIE BLVD STE 101
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City | NORTHBROOK
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State | IL
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Zip | 60062-2817
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Country | US
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Telephone | 847-433-2030
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Fax | 224-676-0412
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Provider Business Mailing Address
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Address Line | 1508 CANBURY CT UNIT D-1
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City | WHEELING
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State | IL
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Zip | 60090-6971
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Country | US
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Telephone | 847-433-2030
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Fax | 224-676-0412
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Authorized Official
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Title or Position | PRESIDENT, CLINICAL PSYCHOLOGIST
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Name | DR. CHERYL SPIELMAN
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Credential | PSY.D.
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Telephone | 847-433-2030
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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 | 071-003964
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License Number State | IL
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