Basic Information
| Provider Information | |||||||||
| NPI: | 1003018268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DALEY | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7251 RANDOLPH ST APT A7 | ||||||||
| Address2: | |||||||||
| City: | FOREST PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601301332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7736159477 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 30 N MICHIGAN AVE | ||||||||
| Address2: | SUITE 1510 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606023402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7736159477 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | IL | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.