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Individual

BERNARD P CHAPIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST

Contact information

Practice address
6820 S WASHTENAW AVE, CHICAGO, IL 60629-1826
(773) 548-8705
Mailing address
1500 E 33RD AVE, HOBART, IN 46342-1210
(773) 972-9952

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
542289
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
542289
ILLINOIS ELIS LICENCE NUMBER
IL
Enumeration date
10/22/2019
Last updated
10/22/2019
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