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Individual

DR. PAUL C. LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
222 MERCHANDISE MART PLZ, SUITE #13-659, CHICAGO, IL 60654-1103
(312) 467-0150
(312) 467-0150
Mailing address
222 MERCHANDISE MART PLAZA, SUITE #13-659, CHICAGO, IL 60654-4705
(312) 467-0150
(312) 467-0150

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071003617
IL

Other

Enumeration date
03/08/2007
Last updated
02/03/2010
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