Provider Demographics
NPI:1730449315
Name:MICHAEL PICA P.C.
Entity type:Organization
Organization Name:MICHAEL PICA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PICA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-373-7349
Mailing Address - Street 1:4N701 SCHOOL RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6508
Mailing Address - Country:US
Mailing Address - Phone:630-549-6497
Mailing Address - Fax:630-549-0942
Practice Address - Street 1:4N701 SCHOOL RD STE A
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-6508
Practice Address - Country:US
Practice Address - Phone:630-549-6497
Practice Address - Fax:630-549-0942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty