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Individual

DR. DIANE PIES TOBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
5007 LINCOLN AVE, SUITE 106, LISLE, IL 60532-4187
(630) 470-7921
(630) 629-8048
Mailing address
5007 LINCOLN AVE, SUITE 106, LISLE, IL 60532-4187
(630) 470-7921
(630) 629-8048

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071.007194
IL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
071.007194
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
071007194
LICENSE (CLINICAL PSYCHOLOGIST)
IL
01
1194912824
NPI NUMBER
IL
01
12253092
CAQH
IL
Enumeration date
09/26/2007
Last updated
05/31/2012
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