| Organization Name: | OAK FOREST PSYCHOLOGICAL SERVICE, P.C. |
| NPI Number: | 1225209414 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMIRA SWEIS (OFFICE MANAGER) |
| Mailing Address: | 133 Mohawk Dr Bourbonnais |
| State: | IL US |
| Postal Code: | 609141349 |
| Phone Number: | 7088621260 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2008 |
| NPI Last Update Date: | 03/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |