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DR JOSEPH WALLACH PHD LLC NPI 1861758583


NPI Information

NPI: 1861758583
Provider Name: DR JOSEPH WALLACH PHD LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
4753 N BROADWAY ST
SUITE 608
CHICAGO, IL
ZIP 60640
Phone: (773) 852-2400
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DR JOSEPH WALLACH PHD LLC is a clinical psychologist in Chicago, IL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR JOSEPH WALLACH PHD LLC NPI is 1861758583. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4753 N BROADWAY ST
SUITE 608
CHICAGO, IL
ZIP 60640-266
Phone: (773) 852-2400
Fax: (847) 869-8116

The provider's authorized official is Joseph Wallach .
The authorized official title is Licensed Clinical Psychologist and has the following contact phone number (773) 852-2400.

The enumeration date for this NPI number is 4/6/2012 and was last updated on 4/6/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TB0200XPsychologistCognitive & Behavioral071007942ILLINOISNo
2103TH0004XPsychologistHealth071007942ILLINOISNo
3103TC0700XPsychologistClinical071007942ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.