Individual
DR. LYLE SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LCP
Contact information
Practice address
227 S 2ND ST, GENEVA, IL 60134-2713
(630) 232-2458
Mailing address
227 S 2ND ST, GENEVA, IL 60134-2713
(630) 232-2458
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007295
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004532166
BCBSIL
IL
Enumeration date
05/04/2007
Last updated
02/06/2008
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