Provider Demographics
NPI:1962589457
Name:ERREK, HENRY KEVIN (PHD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:KEVIN
Last Name:ERREK
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 1:9641 W 153RD ST
Mailing Address - Street 2:SUITE 45
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3775
Mailing Address - Country:US
Mailing Address - Phone:708-403-5223
Mailing Address - Fax:
Practice Address - Street 1:9641 W 153RD ST
Practice Address - Street 2:SUITE 45
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3775
Practice Address - Country:US
Practice Address - Phone:708-403-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR17690Medicare UPIN
IL725340Medicare PIN