Organization
RICK TIVERS & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK TIVERS L.C.S.W. (OWNER)
(847) 291-0468
Entity
Organization
Contact information
Practice address
633 SKOKIE BLVD, SUITE 260, NORTHBROOK, IL 60062-2858
(847) 291-0468
(847) 291-0576
Mailing address
633 SKOKIE BLVD, SUITE 260, NORTHBROOK, IL 60062-2858
(847) 291-0468
(847) 291-0576
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617797
BCBS PPO PROVIDER NUMBER
IL
Enumeration date
05/15/2006
Last updated
07/10/2008
Update your record
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