Individual
DR. ANDREW VINCENT SHACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1103 WESTGATE ST, SUITE 200, OAK PARK, IL 60301-1088
(708) 386-8112
(708) 383-4298
Mailing address
1103 WESTGATE ST, SUITE 200, OAK PARK, IL 60301-1088
(708) 386-8112
(708) 383-4298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006231
IL
Other
Enumeration date
05/25/2006
Last updated
02/27/2014
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