Provider Demographics
NPI:1821984568
Name:THE TRAUMA & ANXIETY PSYCHOLOGICAL SERVICES CLINIC
Entity type:Organization
Organization Name:THE TRAUMA & ANXIETY PSYCHOLOGICAL SERVICES CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST & SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-379-8129
Mailing Address - Street 1:2501 CHATHAM RD STE 8366
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4188
Mailing Address - Country:US
Mailing Address - Phone:773-379-8129
Mailing Address - Fax:
Practice Address - Street 1:1114 W BALMORAL AVE APT 1E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1720
Practice Address - Country:US
Practice Address - Phone:773-379-8129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty