Individual
HEATHER EISELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8170 MCCORMICK BLVD, SUITE 204, SKOKIE, IL 60076-2961
(847) 673-0718
Mailing address
8170 MCCORMICK BLVD, SUITE 204, SKOKIE, IL 60076-2961
(847) 673-0718
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071007975
IL
103TH0004X
Health Psychologist
071.007975
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071007975
LICENSE
IL
Enumeration date
10/25/2010
Last updated
09/16/2022
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