Provider Demographics
NPI:1013059187
Name:NEUROPSYCHOLOGICAL CONSULTANTS INC
Entity type:Organization
Organization Name:NEUROPSYCHOLOGICAL CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:M D
Authorized Official - Last Name:DEER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-308-6125
Mailing Address - Street 1:5017 GREEN BAY RD STE 130
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-1782
Mailing Address - Country:US
Mailing Address - Phone:262-671-1334
Mailing Address - Fax:
Practice Address - Street 1:5017 GREEN BAY RD STE 130
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-1782
Practice Address - Country:US
Practice Address - Phone:262-671-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001635716OtherBLUE CROSS BLUE SHIELD
IL0001635716OtherBLUE CROSS BLUE SHIELD