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NPI Code Detail

MEDICARE: DR. MICHAEL L FIELDS PH.D.

MEDICARE: DR. MICHAEL L FIELDS 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
1103TC0700XClinical Psychologist071-003671IL

General Provider Information

NPI Number : 1437375706
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL L FIELDS PH.D.
Provider Business Mailing Address
First Line : 77 W WASHINGTON ST STE 616
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3281
Country : US
Telephone Number : 312-345-1550
Fax Number : 312-345-1551
Provider Business Practice Location Address
First Line : 77 W WASHINGTON ST STE 616
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3281
Country : US
Telephone Number : 312-345-1550
Fax Number : 312-345-1551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 12/17/2020

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