Provider Demographics
NPI:1609618180
Name:ULRICH, DEVIN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:MARIE
Last Name:ULRICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3150
Mailing Address - Country:US
Mailing Address - Phone:210-724-5068
Mailing Address - Fax:
Practice Address - Street 1:1725 W HARRISON ST STE 755
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3863
Practice Address - Country:US
Practice Address - Phone:312-563-2030
Practice Address - Fax:312-563-2024
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist