Organization
NEUROBEHAVIORAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R MYERS PSY.D. (OWNER)
(773) 972-4248
Entity
Organization
Contact information
Practice address
1755 PARK ST, #200, NAPERVILLE, IL 60563-4861
(630) 449-4270
(630) 820-2358
Mailing address
1755 PARK ST, #200, NAPERVILLE, IL 60563-4861
(630) 449-4270
(630) 820-2358
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071007744
IL
103TC0700X
Clinical Psychologist
071007744
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL8063
PTAN
IL
Enumeration date
07/25/2012
Last updated
11/01/2013
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