Organization
JUDITH A. HOLMES, PHD., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH A. HOLMES PH.D. (PRESIDENT)
(847) 296-3442
Entity
Organization
Contact information
Practice address
1440 RENAISSANCE DRIVE, SUITE 200, PARK RIDGE, IL 60068
(847) 296-3442
(847) 296-3543
Mailing address
1440 RENAISSANCE DRIVE, SUITE 200, PARK RIDGE, IL 60068
(847) 296-3442
(847) 296-3543
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071004106
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01673546
BLUE SHIELD
IL
Enumeration date
10/03/2006
Last updated
08/16/2013
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