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NPI Code Detail

MEDICARE: DR. JUDITH ANN SKERCHOCK PH.D.

MEDICARE: DR. JUDITH ANN SKERCHOCK PH.D.
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
1101YM0800XMental Health Counselor071002972IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117275282OTHERAPA MEMBER NUMBER
2071002972OTHERILSTATE LICENSE
333433OTHERNATIONAL REGISTER HEALTH

General Provider Information

NPI Number : 1124095492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH ANN SKERCHOCK PH.D.
Provider Business Mailing Address
First Line : 1129 TAYLORSPORT LN
Second Line :
City : WINNETKA
State : IL
Zip : 60093-1543
Country : US
Telephone Number : 847-446-3132
Fax Number : 847-446-6289
Provider Business Practice Location Address
First Line : 25 E WASHINGTON ST
Second Line : STE 1801
City : CHICAGO
State : IL
Zip : 60602
Country : US
Telephone Number : 312-263-1777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2006
Last Update Date : 03/08/2020

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