Funk, Roger Keith
Funk, Roger Keith is an sole proprietor health care provider with primary practice located at 655 Landwehr Rd , Northbrook IL 60062-2311. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Funk, Roger Keith can be contacted via phone (847) 498-1699.Contact Information
Primary practice address
655 Landwehr Rd
Northbrook IL 60062-2311
Phone: (847) 498-1699
Fax: (847) 239-6029
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | Illinois |
Profile Details
| NPI number | 1851437628 |
|---|---|
| LBN Legal business name | Funk, Roger Keith |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851437628 | NPPES |
| Illinois | Other | 1672646 | BLUE CROSS BLUE SHIELD |
| Illinois | Other | 212754 | BLUE CROSS BLUE SHIELD |
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