Individual
DR. JOSEPH ELI WALLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2530 CRAWFORD AVE, SUITE 304, EVANSTON, IL 60201-4970
(773) 852-2400
(847) 869-8116
Mailing address
2741 W GREENLEAF AVE, CHICAGO, IL 60645-3013
(773) 852-2400
(773) 856-3517
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
071007942
IL
103TC0700X
Clinical Psychologist
Primary
071007942
IL
103TH0004X
Health Psychologist
071007942
IL
Other
Enumeration date
08/03/2010
Last updated
12/22/2011
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