Individual
DR. LOUIS JOSEPH FORMICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3660 N LAKE SHORE DR STE 201, CHICAGO, IL 60613-5302
(773) 759-5126
Mailing address
3660 N LAKE SHORE DR STE 201, CHICAGO, IL 60613-5302
(773) 759-5126
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010375
IL
103TC1900X
Counseling Psychologist
071.010375
IL
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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