Doctor Name: | WILLIAM PUGA |
NPI Number: | 1427011170 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036073342 |
Business Practice Address: | 1400 E Irving Park Rd Streamwood, IL - 601073201 |
Business Phone Number: | 3307584515 |
Business Fax Number: | 3307585121 |
Mailing Address: | 1400 E Irving Park Rd, STREAMWOOD |
State: | IL |
Postal Code: | 601073201 |
Phone Number: | 3307584515 |
Fax Number: | 3307585121 |
NPI Enumeration Date: | 04/11/2006 |
NPI Last Update Date: | 01/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 036073342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |