Pcpa Legacy, LLC
NPI #1093030132 in Northbrook, Illinois
Provider Information
- NPI Number
- 1093030132
- Entity Type
- Organization
- Organization Name
- Pcpa Legacy, LLC
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Apr 1, 2010
- Last Updated
- Sep 6, 2023
Practice Location
- Address
- 400 SKOKIE BLVD STE 245
- City
- Northbrook
- State
- Illinois
- ZIP Code
- 60062-7932
- Phone
- (847) 630-1611
Authorized Official
- Name
- DR. PAUL C KREDOW, PSYD
- Title
- PROVIDER/OWNER
- Phone
- (847) 630-1611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent |
| Psychologist - Clinical — Clinical |
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