Shiraz Tata Phd Llc is a Clinical - Psychology Clinic in Rockford, Illinois. It is located at 6072 Brynwood Dr Ste 107, Rockford, IL and its contact number is 815-519-2949. The authorized person for Shiraz Tata Phd Llc is Shiraz P Tata
who is Licensed Clinical Psychologist of the clinic and his/her contact number is 815-519-2949. The primary license number for Shiraz Tata Phd Llc is 071.04963 (Clinical) in Illinois. Shiraz Tata Phd Llc Clinic has mental health professionals specialized in the diagnosis and psychological treatment of mental, behavioral and emotional illnesses, including obsessive-compulsive disorder (OCD). Psychologists main focus is on diagnosing and treating mental, emotional, and behavioral disorders. Some of the common disorders that psychologists can treat are learning disabilities, substance abuse, depression, anxiety, and eating disorders.
Complete Clinic Profile:
Shiraz Tata Phd Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Shiraz Tata Phd Llc
Specialization:
Clinical Psychology
Clinic Address:
6072 Brynwood Dr Ste 107, Rockford, Illinois, 61114
Phone:
815-519-2949
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Shiraz P Tata
Position:
Licensed Clinical Psychologist
Contact Number:
815-519-2949
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Shiraz Tata Phd Llc clinic are as mentioned below.
NPI Number:
1083109524
NPI Enumeration Date:
27 Jun, 2018
NPI Last Update On:
01 Aug, 2018
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shiraz Tata Phd Llc are as mentioned below.
Specialization
License Number
State
Status
Clinical
071.04963
Illinois
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
819809569
Other
Bcbsil
11740000
Other
Caqh
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Patients can reach Shiraz Tata Phd Llc at 6072 Brynwood Dr Ste 107, Rockford, Illinois or can call to book an appointment on 815-519-2949. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.