Organization Name: | NORTH SHORE PSYCHOLOGICAL SERVICES LTD |
NPI Number: | 1235265794 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEIL D MAHONEY (PARTNER) |
Mailing Address: | 900 North Shore Dr Suite 200 Lake Bluff |
State: | IL US |
Postal Code: | 600442243 |
Phone Number: | 8472950340 |
Fax Number: | 8472950351 |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 01/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071003138 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |