Provider Demographics
NPI:1285138529
Name:ATLAS, HOWARD W (EDD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:W
Last Name:ATLAS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 LEGENDS CT
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3856
Mailing Address - Country:US
Mailing Address - Phone:847-363-7954
Mailing Address - Fax:847-964-9833
Practice Address - Street 1:2341 LEGENDS CT
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3856
Practice Address - Country:US
Practice Address - Phone:847-363-7954
Practice Address - Fax:847-964-9833
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL975582103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool