NPI 1891944484

Health Providers

Organisation Psychoanalyst Glenwood, IL

Practice location

Address: 19330 S Cottage Grove Ave, Glenwood, IL 60425-1834
Phone: (708) 758-6200
Mailing address: 1507 W Polk St, Chicago, IL 60607-3120

Authorised official

Name: Keith O Roper
Title: Owner
Phone: (312) 421-3434

Registered specialties

Psychoanalyst Primary

Behavioral Health & Social Service Providers Taxonomy 102L00000X Licence 036055359 (IL)

Other Psychoanalyst providers in Illinois →

Registry record

NPI: 1891944484
Entity type: Organization
NPI issued: 18 Sep 2008
Record last updated: 18 Sep 2008

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.