Provider Demographics
NPI:1104049287
Name:ATELLA, MICHAEL DENNIS (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:ATELLA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 S ROSELLE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-3187
Mailing Address - Country:US
Mailing Address - Phone:847-584-0653
Mailing Address - Fax:847-301-9257
Practice Address - Street 1:651 SOUTH ROSELLE ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-3187
Practice Address - Country:US
Practice Address - Phone:847-584-0653
Practice Address - Fax:847-301-9257
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical