Organization
CHICAGO PRACTICE IN PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW BLAKE SUTH PH.D. (PRESIDENT)
(773) 718-0364
Entity
Organization
Contact information
Practice address
53 WEST JACKSON, SUITE 602, CHICAGO, IL 60604-3448
(773) 718-0364
(312) 212-1705
Mailing address
53 WEST JACKSON, SUITE 602, CHICAGO, IL 60604-3448
(773) 718-0364
(312) 212-1705
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006431
IL
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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