Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071006567 | IL |
Y | 103TC0700X | Clinical Psychologist | 071006567 | IL |
NPI | 1003272105 |
---|---|
Provider Name | Dr. Yuleung Eric To |
First Address | Park Ridge, IL 60068-1329 |
Second Address | Park Ridge, IL 60068-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2016 |
Last Update Date | 06/01/2016 |