Individual
DORIS M VAN BYSSUM I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1725 S NAPERVILLE RD, SUITE 206, WHEATON, IL 60189-5805
(630) 653-6441
(630) 653-8409
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
071-004744
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.010527041.189584
IL
Other
Enumeration date
09/06/2006
Last updated
03/14/2017
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