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NPI Code Detail

MEDICARE: SAVANNAH O'BRIEN PSYD PLLC

MEDICARE: SAVANNAH O'BRIEN PSYD PLLC
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 Psychologist

General Provider Information

NPI Number : 1558104265
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAVANNAH O'BRIEN PSYD PLLC
Provider Business Mailing Address
First Line : 3712 N BROADWAY ST # 552
Second Line :
City : CHICAGO
State : IL
Zip : 60613-4235
Country : US
Telephone Number : 231-838-6704
Fax Number :
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 231-838-6704
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. SAVANNAH O'BRIEN
Credential :
Telephone Number : 231-838-6704
Provider Enumeration Date : 06/18/2024
Last Update Date : 03/04/2026

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