Organization
PAUL PASULKA, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL PASULKA PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(312) 266-2136
Entity
Organization
Contact information
Practice address
600 N MCCLURG CT, SUITE 3803A, CHICAGO, IL 60611-3044
(312) 266-2136
(312) 266-6375
Mailing address
600 N MCCLURG CT, SUITE 3803A, CHICAGO, IL 60611-3044
(312) 266-2136
(312) 266-6375
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071000013
IL
103TC0700X
Clinical Psychologist
071000013
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063504124
INDIVIDUAL NPI
IL
Enumeration date
03/14/2012
Last updated
03/14/2012
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