MEDICARE: WILLIAM DEAN BILLOWS PHD HSPP

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
1	103TC0700X	Clinical Psychologist	071.006777	IL

General Provider Information

NPI Number	:	1619969854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM DEAN BILLOWS PHD HSPP

Provider Business Mailing Address
First Line	:	800 E NORTHWEST HWY STE 106
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3457
Country	:	US
Telephone Number	:	847-909-9858
Fax Number	:	847-299-4952

Provider Business Practice Location Address
First Line	:	800 E NORTHWEST HWY STE 106
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3457
Country	:	US
Telephone Number	:	847-909-9858
Fax Number	:	847-299-4952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/21/2022

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