Provider Demographics
NPI:1073645206
Name:PSYCHOLOGICAL RESOURCES, LIMITED
Entity type:Organization
Organization Name:PSYCHOLOGICAL RESOURCES, LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-984-0417
Mailing Address - Street 1:25 E WASHINGTON ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1708
Mailing Address - Country:US
Mailing Address - Phone:312-984-0417
Mailing Address - Fax:312-456-3036
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-984-0417
Practice Address - Fax:312-456-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01618270OtherBLUE CROSS BLUE SHIELD
IL01618270OtherBLUE CROSS BLUE SHIELD