Provider Demographics
NPI:1285297069
Name:NORTHWEST SUBURBAN PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:NORTHWEST SUBURBAN PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCHSCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-326-5125
Mailing Address - Street 1:1020 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3513
Mailing Address - Country:US
Mailing Address - Phone:773-326-5125
Mailing Address - Fax:
Practice Address - Street 1:1020 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3513
Practice Address - Country:US
Practice Address - Phone:773-326-5125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty