Dr. Robert Scott Waller
Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1276 N Clybourn Ave
Chicago
, Illinois 60610
Dr. Robert Scott Waller
Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1276 N Clybourn Ave
Chicago
, Illinois 60610
(239) 248-7437
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About
Features
Specialties
- Addiction Psychologist (Substance Use Disorder)
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Robert Scott Waller
- 1441 W Elmdale Ave Apt 1s
- Chicago, IL
- Zip : 60660-2405
- Phone : (239) 248-7437
Second Address
- Dr. Robert Scott Waller
- 1276 N Clybourn Ave
- Chicago, IL
- Zip : 60610
- Phone : (312) 337-1073
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 071009689 | IL |
| Y | 103G00000X | Clinical Psychologist | 071009689 | IL |
| Y | 103TC0700X | Clinical Psychologist | 071009689 | IL |
National Provider Identifier
| NPI | 1174014625 |
|---|---|
| Provider Name | Dr. Robert Scott Waller |
| First Address | Chicago, IL 60660-2405 |
| Second Address | Chicago, IL 60610 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/05/2018 |
| Last Update Date | 31/07/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.