Organization
LYNN E. NELSON, PSY.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN E. NELSON PSY.D. (PRESIDENT)
(847) 204-1557
Entity
Organization
Contact information
Practice address
3330 OLD GLENVIEW RD, SUITE 15, WILMETTE, IL 60091-2963
(847) 857-0252
Mailing address
3330 OLD GLENVIEW RD, SUITE 15, WILMETTE, IL 60091-2963
(847) 857-0252
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004944
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071004944
PROFESSIONAL LICENSE
IL
Enumeration date
01/17/2006
Last updated
12/07/2009
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