Landreth, Edward Spencer

Landreth, Edward Spencer is an individual health care provider with primary practice located at 4709 Golf Road Suite 1150, Skokie IL 60076-1252. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Landreth, Edward Spencer can be contacted via phone (773) 213-1232.

Contact Information

Primary practice address
4709 Golf Road Suite 1150 Skokie IL 60076-1252
Phone: (773) 213-1232
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071006758 Illinois

Profile Details

NPI number 1104866946
LBN Legal business name Landreth, Edward Spencer
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Apr 6th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104866946 NPPES
Illinois Other 0001635205 BCBS IL

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