Individual
DAVID EDWARD VICTORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2400 CHESTNUT AVE, GLENVIEW PARK CENTER - INTEGRATIVE MEDICINE, SUITE A, GLENVIEW, IL 60026-8321
(847) 657-3540
(847) 657-3530
Mailing address
2650 RIDGE AVE, EVANSTON HOSPITAL, EVANSTON, IL 60201-1718
(847) 570-1206
(847) 570-1248
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-007103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071007103
IL STATE LIC
IL
Enumeration date
05/09/2008
Last updated
05/09/2008
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