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Organization

SUBURBAN CLINICAL SERVICES P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GULLIUME MOOR PSY.D. (OWNER)
(708) 795-4747
Entity
Organization

Contact information

Practice address
222 N MARION ST, OAK PARK, IL 60302-1968
(708) 795-4747
(708) 383-2578
Mailing address
PO BOX 3157, OAK PARK, IL 60303-3157
(708) 795-4747
(708) 383-2578

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071002653
IL

Other

Enumeration date
03/21/2007
Last updated
11/19/2008
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