Individual
PETER A DODZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
415 W GOLF RD STE 16, ARLINGTON HEIGHTS, IL 60005-3923
(847) 577-0904
Mailing address
415 W GOLF RD STE 16, ARLINGTON HEIGHTS, IL 60005-3923
(847) 577-0904
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071006408
IL
103TC0700X
Clinical Psychologist
071006408
IL
103TC0700X
Clinical Psychologist
20041718
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200406360
—
IN
01
—
680015841
RR MEDICARE
IN
Enumeration date
06/30/2005
Last updated
05/09/2022
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