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General NPI Number Information
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NPI Number | 1932193455
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Entity Type | Organization
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Legal Business Name | NEURO-PSYCH TECHNOLOGIES, LTD.
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 01/03/2010
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Provider Practice Location Address
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Address Line | 4711 GOLF RD SUITE 1200
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City | SKOKIE
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State | IL
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Zip | 60076-1224
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Country | US
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Telephone | 847-446-7911
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Fax | 847-386-6239
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Provider Business Mailing Address
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Address Line | PO BOX 8159
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City | NORTHFIELD
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State | IL
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Zip | 60093-8159
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Country | US
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Telephone | 847-446-7911
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Fax | 847-386-6239
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID GEORGE BAWDEN
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Credential | M.D.
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Telephone | 847-446-7911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 042-003570
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License Number State | IL
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