Healthcare Provider Details

I. General information

NPI: 1255348777
Provider Name (Legal Business Name): JAMES ALLEN KOWAL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 N WASHINGTON ST
NAPERVILLE IL
60563-2767
US

IV. Provider business mailing address

1110 N WASHINGTON ST
NAPERVILLE IL
60563-2767
US

V. Phone/Fax

Practice location:
  • Phone: 630-637-4002
  • Fax: 630-637-4002
Mailing address:
  • Phone: 630-637-4002
  • Fax: 630-637-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number180-003245
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: