| Doctor Name: | DR. FAAN YEEN SIDOR |
| NPI Number: | 1134275282 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 071006645 |
| Business Practice Address: | 3001a Sixth St. Bldg 200h 4e Great Lakes, IL - 600882833 |
| Business Phone Number: | 8476882755 |
| Business Fax Number: | 8476882546 |
| Mailing Address: | 3001a Sixth Street, Bldg 200h 4e GREAT LAKES |
| State: | IL |
| Postal Code: | 600882833 |
| Phone Number: | 8476882755 |
| Fax Number: | 8476882546 |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 05/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071006645 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |