Provider Demographics
NPI:1427087766
Name:BILADEAU, MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BILADEAU
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 340-I
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2290
Mailing Address - Country:US
Mailing Address - Phone:773-209-0689
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:SUITE 340-I
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:773-209-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006661103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical