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NPI Code Detail

MEDICARE: DR. DAVID CHARLES USNDEK PSYD LC PC CADC

MEDICARE:  DR. DAVID CHARLES USNDEK  PSYD LC PC CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist071007224IL
2103TC0700XClinical Psychologist4703AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11053773226OTHERAZNPI FOR INSIGHT PSYCHOLOGICAL SERVICES

General Provider Information

NPI Number : 1073684643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID CHARLES USNDEK PSYD LC PC CADC
Provider Business Mailing Address
First Line : 3660 N LAKE SHORE DR STE 201
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5302
Country : US
Telephone Number : 773-450-8049
Fax Number :
Provider Business Practice Location Address
First Line : 3660 N LAKE SHORE DR STE 201
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5302
Country : US
Telephone Number : 773-450-8049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 04/15/2026

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Directions to “ DR. DAVID CHARLES USNDEK PSYD LC PC CADC” Practice Location

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