Organization
GREGORY MALO PSYD & ASSOCIATES IN NEUROPSYCHOLOGY PC
Active
Other names
ARCC Neuropsychology
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WARREN SUMMERVILLE (OWNER)
(630) 424-8900
Entity
Organization
Contact information
Practice address
477 E BUTTERFIELD RD STE 102, LOMBARD, IL 60148-4880
(630) 424-8900
(630) 424-9017
Mailing address
477 E BUTTERFIELD RD STE 102, LOMBARD, IL 60148-4880
(630) 424-8900
(630) 424-9017
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
071002647
IL
Other
Enumeration date
12/26/2006
Last updated
12/05/2022
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