Provider Demographics
NPI:1699787598
Name:TOBIAS, RALPH JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:JOHN
Last Name:TOBIAS
Suffix:
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 1:1037 W PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7044
Mailing Address - Country:US
Mailing Address - Phone:847-525-0810
Mailing Address - Fax:
Practice Address - Street 1:1580 S MILWAUKEE AVE STE 502
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3776
Practice Address - Country:US
Practice Address - Phone:847-525-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005174103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21909Medicare ID - Type Unspecified