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Organization
VAN BYSSUM ASSOCIATES, PC
Active
Organization
VAN BYSSUM ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORIS M VAN BYSSUM PSY.D. (PRESIDENT/OWNER)
(630) 858-0875
Entity
Organization
Contact information
Practice address
174 S MONTCLAIR AVE, GLEN ELLYN, IL 60137-6357
(630) 858-0875
(630) 858-0650
Mailing address
174 S MONTCLAIR AVE, GLEN ELLYN, IL 60137-6357
(630) 858-0875
(630) 858-0650
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071004744
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.010527041.189584
IL
Other
Enumeration date
08/30/2007
Last updated
03/14/2017
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