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Organization

PSYCHOLOGICAL SERVICES OF CENTRAL ILLINOIS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD E. DIMOND PH.D. (PRESIDENT)
(217) 546-3118
Entity
Organization

Contact information

Practice address
2921 GREENBRIAR DR, SUITE B-1, SPRINGFIELD, IL 62704-6425
(217) 546-3118
(217) 546-3184
Mailing address
2921 GREENBRIAR DR, SUITE B-1, SPRINGFIELD, IL 62704-6425
(217) 546-3118
(217) 546-3184

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0008423762
HMO ILLINOIS
IL
Enumeration date
05/12/2006
Last updated
04/20/2008
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