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NPI Code Detail

MEDICARE: DR. ROBERT J MORETTI PH.D.

MEDICARE:  DR. ROBERT J MORETTI  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 PsychologistIL

General Provider Information

NPI Number : 1497866354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT J MORETTI PH.D.
Provider Business Mailing Address
First Line : 63 E LAKE ST
Second Line : SUITE 404
City : CHICAGO
State : IL
Zip : 60601-5921
Country : US
Telephone Number : 312-884-8317
Fax Number : 312-884-8317
Provider Business Practice Location Address
First Line : 63 E LAKE ST
Second Line : SUITE 404
City : CHICAGO
State : IL
Zip : 60601-5921
Country : US
Telephone Number : 312-884-8317
Fax Number : 312-884-8317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ROBERT J MORETTI PH.D.” Practice Location

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