Doctor Name: | DR. TOMASZ P ANDRUSYNA |
NPI Number: | 1023240728 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 071007736 |
Business Practice Address: | 5000 S 5th Ave Hines, IL - 601413030 |
Business Phone Number: | 7082027846 |
Business Fax Number: | |
Mailing Address: | 5000 S 5th Ave, HINES |
State: | IL |
Postal Code: | 601413030 |
Phone Number: | 7082027846 |
Fax Number: | |
NPI Enumeration Date: | 08/13/2009 |
NPI Last Update Date: | 08/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071007736 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |