Individual
DR. EUGENE PAUL HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1800 RAVINIA PL, ORLAND PARK, IL 60462-3761
(708) 403-7570
(708) 403-7546
Mailing address
P. O. BOX 747, BLUE ISLAND, IL 60406-1125
(708) 403-7570
(708) 403-7546
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005108
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634764
BCBSIL
IL
01
—
279826000
MAGELLAN HEALTH SERVICES
IL
Enumeration date
10/31/2006
Last updated
07/30/2010
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