Ingersoll, Michael J

Ingersoll, Michael J is an individual health care provider with primary practice located at 640 S Washington St , Naperville IL 60540-6603. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Ingersoll, Michael J can be contacted via phone (815) 942-6323.

Contact Information

Primary practice address
640 S Washington St Naperville IL 60540-6603
Phone: (815) 942-6323
Fax: (815) 942-6363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071004707 Illinois

Profile Details

NPI number 1487630737
LBN Legal business name Ingersoll, Michael J
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated May 24th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487630737 NPPES
Illinois Other 01618781 BC/BS
Illinois Other 680012120 BC/BS

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