Individual
DR. EUGENE S. CARROCCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4700 W 95TH ST, SUITE LL5, OAK LAWN, IL 60453-2533
(800) 216-1110
(708) 346-4868
Mailing address
PO BOX 776, ADVOCATE FAMILY CARE NETWORK, OAK LAWN, IL 60454-0776
(800) 216-1110
(708) 346-4868
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
071-006067
IL
103TB0200X
Cognitive & Behavioral Psychologist
071-006067
IL
103TC0700X
Clinical Psychologist
Primary
071-006067
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071-006067
IL
103TF0000X
Family Psychologist
071-006067
IL
Other
Enumeration date
04/02/2007
Last updated
05/12/2009
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