Provider Demographics
NPI:1487788816
Name:PURKEL, ARTHUR WARREN JR (PHD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:WARREN
Last Name:PURKEL
Suffix:JR
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 1:426 S LOMBARD AVE
Mailing Address - Street 2:#301
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4234
Mailing Address - Country:US
Mailing Address - Phone:708-302-3864
Mailing Address - Fax:
Practice Address - Street 1:501 N RIVERSIDE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5918
Practice Address - Country:US
Practice Address - Phone:847-263-1269
Practice Address - Fax:847-263-1310
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
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