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General NPI Number Information
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NPI Number | 1952779100
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Entity Type | Organization
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Legal Business Name | JOSH SINGH, PHD
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 1525 E 53RD ST STE 623
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City | CHICAGO
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State | IL
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Zip | 60615-4530
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Country | US
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Telephone | 773-412-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 E 53RD ST STE 623
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City | CHICAGO
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State | IL
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Zip | 60615-4530
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Country | US
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Telephone | 773-412-1150
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLGOIST
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Name | DR. JOSH SINGH
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Credential | PH.D.
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Telephone | 773-412-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 071007416
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License Number State | IL
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