Organization
ASSOCIATES IN CLINICAL PSYCHOLOGY & SUBSTANCE ABUSE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L FARRELL PHD (PRESIDENT)
(708) 957-3695
Entity
Organization
Contact information
Practice address
2024 HICKORY RD STE 103, HOMEWOOD, IL 60430-2158
(708) 957-3662
(708) 957-3695
Mailing address
2024 HICKORY RD STE 103, HOMEWOOD, IL 60430-2158
(708) 957-3662
(708) 957-3695
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1673080
BCBS GROUP PROVIDER NUMBE
IL
Enumeration date
09/01/2006
Last updated
05/19/2020
Update your record
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