Organization
MICHAEL J. ATHANS, PH.D. AND ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES ATHANS PH.D. (DIRECTOR)
(847) 823-4444
Entity
Organization
Contact information
Practice address
32 MAIN ST, SUITE D, PARK RIDGE, IL 60068-4060
(847) 823-4444
(847) 823-4456
Mailing address
32 MAIN ST, SUITE D, PARK RIDGE, IL 60068-4060
(847) 823-4444
(847) 823-4456
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003398
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633134
BLUE CROSS PROVIDER NUMBE
IL
Enumeration date
01/30/2006
Last updated
11/08/2011
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