Individual
DR. ERIN KRISTINA BASALAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5730 W ROOSEVELT RD, CHICAGO, IL 60644-1580
(773) 921-1700
Mailing address
1723 S 5TH PL, ST CHARLES, IL 60174-4324
(847) 529-6421
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008280
IL
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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