Organization
MARCIA PAVLOU PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCIA PAVLOU PHD (CLINICAL PSYCHOLOGIST)
(312) 346-7733
Entity
Organization
Contact information
Practice address
721 N GROVE, OAK PARK, IL 60302
(312) 346-7733
(708) 848-0152
Mailing address
721 N GROVE AVE, OAK PARK, IL 60302-1551
(312) 346-7733
(708) 848-0152
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
711959
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054605000
MAGELLAN
—
01
—
21608111
BCBS OF IL
—
01
—
OR185
IL BCBS
NY
Enumeration date
08/31/2006
Last updated
11/26/2012
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