Individual
ERIC LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-6220
Mailing address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-6220
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071.005100
IL
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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