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General NPI Number Information
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NPI Number | 1922960558
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Entity Type | Individual
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Provider Name | THOMAS RYAN MAHER PSY.D
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Gender | Male
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 4010 N WOLCOTT AVE APT 1N
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City | CHICAGO
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State | IL
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Zip | 60613-6745
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Country | US
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Telephone | 860-941-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 3448 W DIVERSEY AVE
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City | CHICAGO
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State | IL
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Zip | 60647-9740
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Country | US
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Telephone | 773-245-3725
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Fax |
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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 | 071.022409
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License Number State | IL
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