Individual
DR. RAY EDWARD QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4801 W PETERSON AVE, STE 525, CHICAGO, IL 60646-5731
(773) 286-3100
(773) 777-7543
Mailing address
4801 W PETERSON AVE, STE 525, CHICAGO, IL 60646-5731
(773) 286-3100
(773) 777-7543
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
05/26/2005
Last updated
07/08/2007
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