Individual
MR. MICHAEL N. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1653 WEST CONGRESS PARKWAY, 1228 KELLOGG, CHICAGO, IL 60612
(312) 942-6656
(312) 942-8592
Mailing address
1653 WEST CONGRESS PARKWAY, 1223 KELLOGG BUILDING, CHICAGO, IL 60612
(312) 942-6656
(312) 942-8592
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071.003181
IL
103TC0700X
Clinical Psychologist
071-003181
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071.003181
IL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
071.003181
IL
Other
Enumeration date
06/16/2009
Last updated
05/12/2017
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