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NPI Code Detail

MEDICARE: RAUSER PSYCHOLOGICAL SERVICES

MEDICARE: RAUSER PSYCHOLOGICAL SERVICES
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
1305R00000XPreferred Provider OrganizationIL

General Provider Information

NPI Number : 1861660326
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAUSER PSYCHOLOGICAL SERVICES
Provider Business Mailing Address
First Line : 4037 N SHERIDAN RD
Second Line : UNIT 1
City : CHICAGO
State : IL
Zip : 60613-5218
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4037 N SHERIDAN RD
Second Line : UNIT 1
City : CHICAGO
State : IL
Zip : 60613-5218
Country : US
Telephone Number : 773-301-6144
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARK RAUSER
Credential : PSY.D.
Telephone Number : 773-301-6144
Provider Enumeration Date : 02/18/2008
Last Update Date : 02/18/2008

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