Provider Demographics
NPI:1063546539
Name:UNUMB, THERESE M (PHD)
Entity type:Individual
Prefix:DR
First Name:THERESE
Middle Name:M
Last Name:UNUMB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 DUNDEE RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2320
Mailing Address - Country:US
Mailing Address - Phone:847-272-4799
Mailing Address - Fax:847-272-4174
Practice Address - Street 1:3400 DUNDEE RD
Practice Address - Street 2:SUITE 370
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2320
Practice Address - Country:US
Practice Address - Phone:847-272-4799
Practice Address - Fax:847-272-4174
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210793Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST