Individual
PAUL PASULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
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
071-003338
IL
103T00000X
Psychologist
071-003338
IL
103TC0700X
Clinical Psychologist
071-003338
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071-003338
IL
103TF0200X
Forensic Psychologist
071-003338
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01673053
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/28/2006
Last updated
10/12/2010
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