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NPI 1992716625

NPI 1992716625 : CATHRYN A PUSKARICH PH D : WESTMONT, IL

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General NPI Number Information
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    NPI Number           |    1992716625
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    Entity Type          |    Individual 
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    Provider Name        |    CATHRYN A PUSKARICH PH D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/10/2006
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    Last Update Date     |    05/13/2015
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Provider Practice Location Address
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    Address Line         |    999 OAKMONT PLAZA DR SUITE 100
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    City                 |    WESTMONT
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    State                |    IL
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    Zip                  |    60559-5563
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    Country              |    US
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    Telephone            |    630-850-2120
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    Fax                  |    630-850-2123
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Provider Business Mailing Address
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    Address Line         |    999 OAKMONT PLAZA DR SUITE 100
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    City                 |    WESTMONT
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    State                |    IL
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    Zip                  |    60559-5563
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    Country              |    US
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    Telephone            |    630-850-2120
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    Fax                  |    630-850-2123
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    071-004490
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    License Number State |    IL
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