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General NPI Number Information
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NPI Number | 1962951467
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Entity Type | Individual
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Provider Name | ERICA HYMEN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2016
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 3231 N CLIFTON AVE
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City | CHICAGO
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State | IL
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Zip | 60657-9543
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Country | US
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Telephone | 847-507-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 N CLIFTON AVE
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City | CHICAGO
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State | IL
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Zip | 60657-9543
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.009464
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6301019157
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 071.010871
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License Number State | IL
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