Southern Illinois Neuropsychology Llc
Specialty details in registry · Edwardsville, IL
At a glance
60 S State Route 157, Edwardsville, IL 62025
NPPES record updated Feb 10, 2022. Public records can lag behind changes at a practice.
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Practice location
60 S State Route 157Edwardsville, IL 62025
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 103G00000X
- Enumeration date
- Jan 3, 2018
- Record updated
- Feb 10, 2022
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
103G00000X · Primary
License reported: 071009269 IL
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
60 S State Route 157Edwardsville, IL 62025
- Phone
- (618) 391-4021
Mailing address
1 OAK DR UNIT 352MARYVILLE, IL 620627026
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