Provider Demographics
NPI:1528203007
Name:MARY ENGLUND, PSYD., PLLC
Entity type:Organization
Organization Name:MARY ENGLUND, PSYD., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLUND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-639-2777
Mailing Address - Street 1:25 N RIVER LN STE 25485
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2263
Mailing Address - Country:US
Mailing Address - Phone:630-639-2777
Mailing Address - Fax:
Practice Address - Street 1:378 COLONIAL CIR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3639
Practice Address - Country:US
Practice Address - Phone:630-639-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty