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General NPI Number Information
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NPI Number | 1922099019
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Entity Type | Individual
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Provider Name | JUDY G. DZIUGAS PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2005
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Last Update Date | 09/28/2014
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Provider Practice Location Address
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Address Line | 180 W PARK AVE #115
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City | ELMHURST
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State | IL
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Zip | 60126-3357
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Country | US
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Telephone | 630-279-0845
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Fax | 630-530-4441
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Provider Business Mailing Address
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Address Line | 180 W PARK AVE #130
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City | ELMHURST
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State | IL
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Zip | 60126-3357
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Country | US
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Telephone | 630-279-0845
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Fax | 630-530-4441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 071005781
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License Number State | IL
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