Provider Demographics
NPI:1528163078
Name:STUDL, MICHELE OREILLY (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:OREILLY
Last Name:STUDL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 LINCOLN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2349
Mailing Address - Country:US
Mailing Address - Phone:847-441-7774
Mailing Address - Fax:
Practice Address - Street 1:545 LINCOLN AV
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093
Practice Address - Country:US
Practice Address - Phone:847-441-7774
Practice Address - Fax:312-654-9338
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01682424OtherBLUE CROSS BLUE SHIELD
IL947180Medicare PIN