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NEUROPSYCHOLOGY CLINIC PC NPI 1659553444


NPI Information

NPI: 1659553444
Provider Name: NEUROPSYCHOLOGY CLINIC PC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
3100 N DRIES LN
STE 303
PEORIA, IL
ZIP 61604
Phone: (309) 686-9005
Get Directions

NEUROPSYCHOLOGY CLINIC PC is a clinical neuropsychologist in Peoria, 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. NEUROPSYCHOLOGY CLINIC PC NPI is 1659553444. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3100 N DRIES LN
STE 303
PEORIA, IL
ZIP 61604-265
Phone: (309) 686-9005
Fax: (309) 686-9020

The provider's authorized official is Rodney P Kurth .
The authorized official title is Office Manager and has the following contact phone number (309) 686-9005.

The enumeration date for this NPI number is 12/4/2007 and was last updated on 5/20/2013.


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 Neuropsychologist071004929ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Z12891MEDICARE UPIN

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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