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General NPI Number Information
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NPI Number | 1962595645
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Entity Type | Organization
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Legal Business Name | DR. PETER TEMPLE & ASSOCIATES PC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1250 EXECUTIVE PL SUITE 404
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City | GENEVA
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State | IL
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Zip | 60134-3807
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Country | US
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Telephone | 630-232-7245
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Fax | 630-232-7246
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Provider Business Mailing Address
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Address Line | 1250 EXECUTIVE PL SUITE 404
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City | GENEVA
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State | IL
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Zip | 60134-3807
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Country | US
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Telephone | 630-232-7245
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Fax | 630-232-7246
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Authorized Official
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Title or Position | PRESIDENT CLINICAL PSYCHOLOGIST
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Name | DR. PETER R TEMPLE
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Credential | PSYD
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Telephone | 630-232-7245
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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 | IL
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