GREGORY MALO PSYD & ASSOCIATES IN NEUROPSYCHOLOGY PC (NPI# 1932264207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932264207 |
| Entity Type | Organization |
| Organization Name | GREGORY MALO PSYD & ASSOCIATES IN NEUROPSYCHOLOGY PC |
| Practice Address |
246 E Janata Blvd Suite 112 Lombard IL 60148-5317 |
| Practice Telephone | 6304248900 |
| Practice Fax Number | 6304249017 |
| Mailing Telephone | 6304248900 |
| Mailing Fax Number | 6304249017 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2014-03-03 |
| Authorized Official Name | MR. RANDALL W. SUMMERVILLE (OWNER) |
| Authorized Official Telephone | 6304248900 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
071002647 | IL | Ambulatory Health Care Facilities |
| Street Address |
246 E JANATA BLVD SUITE 112 |
| City | LOMBARD |
| State | IL |
| Zip Code | 60148-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568464394 | Andrew A. Roth, M.d.,s.c. | Specialist | 246 E Janata Blvd, Suite 130, Lombard, IL 60148-5317 | 2005-08-11 |
| 1265804330 | Kristin Clifford | Psychologist | 246 E Janata Blvd, Lombard, IL 60148-5317 | 2015-10-28 |
| 1023413754 | Liluke Enterprises LLC | Clinical Medical Laboratory | 246 E Janata Blvd, Suite 260, Lombard, IL 60148-5317 | 2014-10-23 |
| 1740685551 | Patrick Janowicz | Clinical Medical Laboratory | 246 E Janata Blvd, Suite 260, Lombard, IL 60148-5317 | 2014-10-23 |
| 1003107350 | Lisa Marie Borgealt | Chiropractor | 246 E Janata Blvd, Suite 135, Lombard, IL 60148-5317 | 2011-04-20 |
| 1053612994 | Rebound Fitmess and Rehabilitation | Specialist | 246 E Janata Blvd, Suite 135, Lombard, IL 60148-5317 | 2010-11-09 |
| 1366751489 | Optimal Dental Lombard PC | Dentist | 246 E Janata Blvd, Suite 140, Lombard, IL 60148-5317 | 2010-10-07 |
| 1558426924 | Gregory Dean Malo | Psychologist | 246 E Janata Blvd, Suite 140, Lombard, IL 60148-5317 | 2006-12-26 |
| 1629138839 | Moira Ann Clair Dammrich | Counselor | 246 E Janata Blvd, Suite 112, Lombard, IL 60148-5317 | 2006-12-11 |
| 1821180803 | Randall Warren Summerville | Clinical Neuropsychologist | 246 E Janata Blvd, Suite 140, Lombard, IL 60148-5317 | 2006-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778919 | Alish Kuply | Pharmacist | 2050 S Finley Rd Suite 20, Lombard, IL 60148 | 2020-04-06 |
| 1114567880 | Danielle Slansky | Speech-Language Pathologist | 401 N. Main St, Lombard, IL 60148 | 2020-01-10 |
| 1245715572 | Ellen Mary Corey | Behavior Technician | 627 S Grace St., Lombard, IL 60148 | 2018-10-02 |
| 1194204461 | Vip 2u, Inc | Internal Medicine | 477 E Butterfield Rd Ste 400, Lombard, IL 60148 | 2018-08-08 |
| 1881185684 | Samantha Lanagan | Behavior Technician | 21 W 356 Sidney Ave, Lombard, IL 60148 | 2018-05-29 |
| 1629570114 | Iris Victoria Goss | Hearing Instrument Specialist | 412 E. Roosevelt Rd, Lombard, IL 60148 | 2018-03-01 |
| 1780102350 | Richard Wong | Dentist | 845 S. Main St #300, Lombard, IL 60148 | 2017-09-05 |
| 1033637038 | Lora Lea Biesenkamp | Counselor | 450 E 22nd St Ste 150-17, Lombard, IL 60148 | 2017-08-30 |
| 1609392836 | Shafiq Ur Rehman | Specialist/Technologist, Other | 2005 South Finley Rd Unit 1012, Lombard, IL 60148 | 2017-08-18 |
| 1033642715 | Great Lakes Living Solutions Corp. | Home Health | 477 E. Butterfield Rd., Suite Ll005, Lombard, IL 60148 | 2017-04-09 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225457500 | Kristine C Hudzik | Clinic/Center | 380 E Saint Charles Rd Unit 741, Lombard, IL 60148-7831 | 2014-04-15 |
| 1134485774 | James M. Abec, Phd, Ltd | Clinic/Center | 477 E Butterfield Rd, Suite 201, Lombard, IL 60148-5618 | 2012-04-09 |
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| 1962017665 | Hopeology, Pllc | Clinic/Center | 700 E North St Ste B, Elburn, IL 60119-7009 | 2020-09-10 |
| 1013521301 | Self Connected Therapy LLC | Clinic/Center | 2189 N. Rt. 83, #292, Round Lake Beach, IL 60073 | 2020-09-03 |
| 1508479288 | Bash Psychotherapy Corporation | Clinic/Center | 413 E Berry Rd, Barrington, IL 60010-3317 | 2020-08-24 |
| 1326658402 | Ventura Counseling, LLC | Clinic/Center | 620 Manchester Ave, Westchester, IL 60154-2714 | 2020-08-04 |
| 1265040760 | Orchid Counseling Chicago | Clinic/Center | 451 W Melrose St Apt 610, Chicago, IL 60657-3826 | 2020-07-21 |
| 1164040630 | Sunshine Therapy Pllc | Clinic/Center | 3328 N Bell Ave, Chicago, IL 60618-6204 | 2020-07-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.