1154479368 NPI number — CONSULTING PSYCHOLOGICAL SERV. P.C.

Table of content: (NPI 1154479368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154479368 NPI number — CONSULTING PSYCHOLOGICAL SERV. P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONSULTING PSYCHOLOGICAL SERV. P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR DON J. FEENEY, JR.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154479368
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20146 S PINE HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKFORT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60423-8372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-921-3827
Provider Business Mailing Address Fax Number:
815-806-8065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7550 HOHMAN AVE
Provider Second Line Business Practice Location Address:
SUITE 1200A
Provider Business Practice Location Address City Name:
MUNSTER
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46321-1060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-921-3827
Provider Business Practice Location Address Fax Number:
815-806-8065
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FEENEY
Authorized Official First Name:
DON
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
708-921-3827

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  060.007209071.002558 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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