Organization
GOLDSTEIN NEUROPSYCHOLOGISTS PC
Active
Other names
Michigan Avenue Neuropsychologists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA SUSAN GOLDSTEIN PH.D., ABPP (PRESIDENT & CEO)
(312) 212-1776
Entity
Organization
Contact information
Practice address
200 S MICHIGAN AVE, SUITE 710, CHICAGO, IL 60604-2402
(312) 212-1776
(312) 212-1778
Mailing address
200 S MICHIGAN AVE, SUITE 710, CHICAGO, IL 60604-2402
(312) 212-1776
(312) 212-1778
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071006006
IL
103G00000X
Clinical Neuropsychologist
20041441A
IN
103T00000X
Psychologist
071006006
IL
103T00000X
Psychologist
20041441A
IN
103TA0700X
Adult Development & Aging Psychologist
071006006
IL
103TA0700X
Adult Development & Aging Psychologist
20041441A
IN
103TC0700X
Clinical Psychologist
071006006
IL
103TC0700X
Clinical Psychologist
20041441A
IN
Other
Enumeration date
01/28/2007
Last updated
06/08/2009
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