Organization · Type 2 NPI
Aeries Healthcare of Illinois Physician Group
Prescribing (Medical) Psychologist · Forest Park, IL
Practice location
8311 W Roosevelt Rd
Forest Park, IL 60130
Mailing address
PO Box 840936
Dallas, TX 72584
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prescribing (Medical) Psychologist Primary | 103TP0016X | None listed |
Prescribing (Medical) Psychologist: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or…
Another provider at this address
About NPI 1083841076
Aeries Healthcare of Illinois Physician Group's National Provider Identifier is 1083841076, issued on Jun 17, 2009. The primary taxonomy on file is Prescribing (Medical) Psychologist (103TP0016X), and the practice location is in Forest Park, IL. The record was last updated on Jun 17, 2009.