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NPI Code Detail

MEDICARE: SAVANNAH O'BRIEN

MEDICARE: SAVANNAH O'BRIEN
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 Psychologist071.010991IL

General Provider Information

NPI Number : 1962180893
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH O'BRIEN
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 : 312-967-4669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2023
Last Update Date : 03/04/2026

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1477839629 — BORAMIE KIM NOORDHOFF LCPC
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Directions to “ SAVANNAH O'BRIEN ” Practice Location

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