Organization
LYNNE M. SIMON PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNNE M. SIMON PH.D. (PRESIDENT)
(847) 328-8779
Entity
Organization
Contact information
Practice address
636 CHURCH ST STE 619A, EVANSTON, IL 60201-4586
(847) 328-8779
Mailing address
404 CHURCH ST, EVANSTON, IL 60201-4514
(847) 328-8779
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003423
IL
Other
Enumeration date
06/08/2007
Last updated
03/05/2013
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