Provider Demographics
NPI:1063576478
Name:PSYCHOSOCIAL INTERVENTIONS, P.C.
Entity type:Organization
Organization Name:PSYCHOSOCIAL INTERVENTIONS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-618-1921
Mailing Address - Street 1:977 LAKEVIEW PKWY
Mailing Address - Street 2:SUITE 1008
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1400
Mailing Address - Country:US
Mailing Address - Phone:312-618-1921
Mailing Address - Fax:847-816-8881
Practice Address - Street 1:977 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 1008
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1400
Practice Address - Country:US
Practice Address - Phone:312-618-1921
Practice Address - Fax:847-816-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty