Illinois Geriatric Psychological Services P.c.

NPI #1184999310 in Harvard, Illinois

Provider Information

NPI Number: 1184999310
Entity Type: Organization
Organization Name: Illinois Geriatric Psychological Services P.c.
Primary Specialty: Psychologist - Clinical
Enumeration Date: Mar 21, 2012
Last Updated: Mar 21, 2012

Practice Location

Address: 503 4TH ST
City: Harvard
State: Illinois
ZIP Code: 60033-2311
Phone: (815) 212-3209

Authorized Official

Name: PETER M KOEHN, PH.D.
Title: PRESIDENT
Phone: (815) 212-3209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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