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Organization

CENTER FOR COMPREHENSIVE NEUROBEHAVIORAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI G TALL PSYD (EXECUTIVE DIRECTOR)
(801) 953-4371
Entity
Organization

Contact information

Practice address
65 E WACKER PL STE 300, CHICAGO, IL 60601-7203
(801) 953-4371
Mailing address
65 E WACKER PL STE 300, CHICAGO, IL 60601-7203
(801) 953-4371

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
01/08/2021
Last updated
01/08/2021
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