Individual
DR. ANNA R BASOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LCPC
Contact information
Practice address
601 SKOKIE BLVD, SUITE #LL-5D, NORTHBROOK, IL 60062-2851
(847) 607-1589
(847) 881-0839
Mailing address
601 SKOKIE BOULEVARD, SUITE #LL-5D, NORTHBROOK, IL 60060-2813
(847) 607-1589
(847) 881-0839
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.007955
IL
101YP2500X
Professional Counselor
180.009063
IL
103TC0700X
Clinical Psychologist
Primary
071009153
IL
Other
Enumeration date
08/07/2012
Last updated
10/28/2015
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