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General NPI Number Information
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NPI Number | 1942079926
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Entity Type | Organization
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Legal Business Name | PETER PLATTEN PLLC
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Dates
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Enumeration Date | 01/01/2024
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 4765 N LINCOLN AVE STE 209
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City | CHICAGO
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State | IL
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Zip | 60625-2077
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Country | US
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Telephone | 714-719-6740
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Fax |
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Provider Business Mailing Address
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Address Line | 4765 N LINCOLN AVE STE 209
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City | CHICAGO
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State | IL
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Zip | 60625-2077
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Country | US
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Telephone | 714-719-6740
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. PETER PLATTEN
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Credential | PHD
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Telephone | 714-719-6740
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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