Individual
DR. JOHN MICHAEL EPPOLITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
405 ILLINOIS AVE, STE 2C, ST CHARLES, IL 60174-2963
(630) 377-3535
(630) 530-9527
Mailing address
405 ILLINOIS AVE, STE 2C, ST CHARLES, IL 60174-2963
(630) 377-3535
(630) 530-9527
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032240598; 00445400
BC/BS PROVIDER NUMBER
IL
Enumeration date
08/18/2006
Last updated
07/08/2007
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