Paul Pasulka, PH.D., P.C.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071000013 Issued in IL

Legal business name

PAUL PASULKA, PH.D., P.C.

Practice address

600 N McClurg CT
Suite 3803a
Chicago, IL 60611-3044

Phone

(312) 266-2136

Fax

(312) 266-6375

NPI assigned

Mar 14, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul Pasulka, PH.D.

Title

Licensed Clinical Psychologist

Phone

(312) 266-2136

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1053686717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "SUITE 3803A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113044",
            "telephone_number": "312-266-2136",
            "fax_number": "312-266-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "SUITE 3803A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113044",
            "telephone_number": "312-266-2136",
            "fax_number": "312-266-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL PASULKA, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "PASULKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-266-2136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071000013",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071000013",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1063504124",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Paul V. Harris, PSYD, P.C.
• Paul Wiemerslage LCSW LLC

• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.