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GOLDSTEIN NEUROPSYCHOLOGISTS PC NPI 1063568210


NPI Information

NPI: 1063568210
Provider Name: GOLDSTEIN NEUROPSYCHOLOGISTS PC

Doing Business As: MICHIGAN AVENUE NEUROPSYCHOLOGISTS

Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization

CLIA Number: 14D0694244

Address:
200 S MICHIGAN AVE
SUITE 710
CHICAGO, IL
ZIP 60604
Phone: (312) 212-1776
Get Directions

GOLDSTEIN NEUROPSYCHOLOGISTS PC is a clinical neuropsychologist in Chicago, IL. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. GOLDSTEIN NEUROPSYCHOLOGISTS PC NPI is 1063568210. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Michigan Avenue Neuropsychologists.

The provider's business location address is:

200 S MICHIGAN AVE
SUITE 710
CHICAGO, IL
ZIP 60604-402
Phone: (312) 212-1776
Fax: (312) 212-1778

The provider's authorized official is Diana Susan Goldstein .
The authorized official title is President & Ceo and has the following contact phone number (312) 212-1776.

The CLIA number assigned to this NPI record is 14D0694244 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2007 and was last updated on 6/8/2009.


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
1103G00000XClinical Neuropsychologist20041441AINDIANANo
2103TA0700XPsychologistAdult Development & Aging071006006ILLINOISNo
3103TA0700XPsychologistAdult Development & Aging20041441AINDIANANo
4103TC0700XPsychologistClinical071006006ILLINOISNo
5103TC0700XPsychologistClinical20041441AINDIANANo
6103T00000XPsychologist071006006ILLINOISNo
7103T00000XPsychologist20041441AINDIANANo
8103G00000XClinical Neuropsychologist071006006ILLINOISYes

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: 11/14/2023

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