NPI 1003161225

Oak Park Behavioral Medicine LLC

Organisation Clinical Psychologist Oak Park, IL

Practice location

Address: 818 Harrison St Suite 210, Oak Park, IL 60304-1144
Phone: (312) 725-6175
Mailing address: 824 S Grove Ave, Oak Park, IL 60304-1125

Authorised official

Name: Tiffany Taft
Title: Owner
Phone: (312) 725-6175

Registered specialties

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 071008285 (IL)

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Registry record

NPI: 1003161225
Entity type: Organization
NPI issued: 14 Jul 2012
Record last updated: 14 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.