Individual
DR. AMBERLY R. PANEPINTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4653 N BROADWAY ST, SUITE 530, CHICAGO, IL 60640-5011
(312) 310-8560
Mailing address
2635 N TALMAN AVE # 3S, CHICAGO, IL 60647-9409
(312) 310-8560
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636536
BCBS
IL
Enumeration date
01/13/2007
Last updated
07/08/2007
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