Richenel Samuel Ellecom PSY.D; DR.P.H

NPI 1063406569 - Clinical Neuropsychologist - 103G00000X

NPI Details
NPI 1063406569
Gender Male
Enumeration Date 09/12/2005
Last Updated 10/27/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
621 PLAINFIELD RD
SUITE 110
WILLOW BROOK IL, 60527-5343, US
Phone (630) 654-1377
Fax (630) 654-2575
Business Location
621 PLAINFIELD RD
SUITE 110
WILLOW BROOK IL, 60527-5343, US
Phone (630) 654-1377
Fax (630) 654-2575
Toxanomy
Taxonomy Code 103G00000X
License State Illinois
License Number 71-5240
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According to our database, Dr. Richenel Samuel Ellecom PSY.D; DR.P.H NPI is 1063406569, taxonomy code is 103G00000X and license number is 71-5240, license state is located at Illinois. Richenel Samuel Ellecom PSY.D; DR.P.H physically located at 621 Plainfield Rd, Willow Brook IL, 60527-5343. NPI Number Richenel Samuel Ellecom PSY.D; DR.P.H has the Individual type.

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1063406569 NPI number is provided on an as is basis without warranty of any kind. 1063406569 is maintained by the National Plan & Provider Enumeration System. The contents of Richenel Samuel Ellecom PSY.D; DR.P.H are for informational purposes only.