MEDICARE: DR. PAUL AARON CANTZ PSY.D., ABPP

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	103T00000X	Psychologist	071008080	IL
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	071008080	IL
3	103TC2200X	Clinical Child & Adolescent Psychologist	071008080	IL
4	103TF0000X	Family Psychologist	071008080	IL
5	103TP0814X	Psychoanalysis Psychologist	071008080	IL
6	103TP2701X	Group Psychotherapy Psychologist	071008080	IL
7	103TC0700X	Clinical Psychologist	071008080	IL

General Provider Information

NPI Number	:	1730485772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL AARON CANTZ PSY.D., ABPP

Provider Business Mailing Address
First Line	:	9444 KEELER AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-1443
Country	:	US
Telephone Number	:	847-877-9578
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 N DEARBORN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-4310
Country	:	US
Telephone Number	:	773-761-0013
Fax Number	:

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

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	03/29/2021

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