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NPI Code Detail

MEDICARE: DR. PAUL JOHN SKIBA PSY.D.

MEDICARE: DR. PAUL JOHN SKIBA PSY.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
1103TC0700XClinical Psychologist071007241IL

General Provider Information

NPI Number : 1326161324
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL JOHN SKIBA PSY.D.
Provider Business Mailing Address
First Line : 10655 YELLOWSTONE DR
Second Line :
City : HUNTLEY
State : IL
Zip : 60142-8171
Country : US
Telephone Number : 708-721-8442
Fax Number :
Provider Business Practice Location Address
First Line : 3436 N KENNICOTT AVE
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-7814
Country : US
Telephone Number : 847-952-7460
Fax Number : 847-222-1754
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 09/05/2018

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