Organization
BLUE LOTUS NEUROPSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHELSEA COOPER PSY.D. (MANAGING PARTNER)
(847) 220-4365
Entity
Organization
Contact information
Practice address
636 CHURCH ST STE 307, EVANSTON, IL 60201-4579
(847) 220-4365
Mailing address
636 CHURCH ST STE 307, EVANSTON, IL 60201-4579
(847) 220-4365
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/13/2022
Last updated
01/03/2024
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