Individual
DR. WAYNE ANDREW PREPURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD COUNSELLING PSYC
Contact information
Practice address
501 W PETERSON RD, ALLIED PSYCHOLOGICAL SERVICES LTD, LIBERTYVILLE, IL 60048
(847) 680-3828
(847) 680-3844
Mailing address
501 W PETERSON RD, ALLIED PSYCHOLOGICAL SERVICES LTD, LIBERTYVILLE, IL 60048
(847) 680-3828
(847) 680-3844
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
103TC0700X
Clinical Psychologist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4923581
BLUE CROSS BLUE SHIELD OF
IL
Enumeration date
08/09/2007
Last updated
08/09/2007
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