Basic Information
Provider Information
NPI: 1205882313
EntityType: 2
ReplacementNPI:  
OrganizationName: NEUROPSYCHOLOGICAL SERVICES PC
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Mailing Information
Address1: 3375 N ARLINGTON HEIGHTS RD
Address2: SUITE K
City: ARLINGTON HEIGHTS
State: IL
PostalCode: 600047701
CountryCode: US
TelephoneNumber: 8473944174
FaxNumber: 8473944176
Practice Location
Address1: 3375 N ARLINGTON HEIGHTS RD
Address2: SUITE K
City: ARLINGTON HEIGHTS
State: IL
PostalCode: 600047701
CountryCode: US
TelephoneNumber: 8473944174
FaxNumber: 8473944176
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 03/09/2015
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AuthorizedOfficialLastName: BYLSMA
AuthorizedOfficialFirstName: FREDERICK
AuthorizedOfficialMiddleName: WILBURN
AuthorizedOfficialTitleorPosition: OWNER, PRESIDENT
AuthorizedOfficialTelephone: 8477384528
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialNamePrefix: DR.
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AuthorizedOfficialCredential: PH.D.
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistClinical
103TA0700X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
103TC2200X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
103TB0200X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
103TC1900X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistCounseling
103TF0000X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistFamily
103TF0200X  N193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologistForensic
103G00000X  Y193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersClinical Neuropsychologist 

No ID Information.


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