Individual
MARIO B. NATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
910 SKOKIE BLVD, SUITE 101, NORTHBROOK, IL 60062-4032
(847) 480-1350
Mailing address
910 SKOKIE BLVD, SUITE 101, NORTHBROOK, IL 60062-4032
(847) 480-1350
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005027
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21620045
BCBS OF IL PROVIDER ID
IL
Enumeration date
03/07/2007
Last updated
09/15/2022
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