Individual
DR. COURTNEY M WEST BLASKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
600 N MCCLURG CT, #3803A, CHICAGO, IL 60611-3044
(312) 246-9166
Mailing address
600 N MCCLURG CT, #3803A, CHICAGO, IL 60611-3044
(312) 246-9166
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071007265
IL
103TC0700X
Clinical Psychologist
Primary
071007265
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071007265
IL
Other
Enumeration date
06/04/2008
Last updated
06/15/2011
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