Provider Demographics
NPI:1548339955
Name:HURLEY, STEVEN E (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:HURLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:HURLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:756 DALTON LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-3214
Mailing Address - Country:US
Mailing Address - Phone:630-885-7131
Mailing Address - Fax:
Practice Address - Street 1:1800 HOLLISTER DR
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5263
Practice Address - Country:US
Practice Address - Phone:847-636-3610
Practice Address - Fax:847-932-4066
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007009103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical