Individual
DR. COURTNEY KEENE VISCOMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, BCBA
Contact information
Practice address
100 SAUNDERS RD STE 150, LAKE FOREST, IL 60045-2526
(760) 576-9931
Mailing address
1451 MERCHANT DR, ALGONQUIN, IL 60102-5917
(847) 469-7537
(847) 469-7540
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071.010347
IL
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
30968
CA
Other
Enumeration date
10/01/2012
Last updated
12/27/2023
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