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General NPI Number Information
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NPI Number | 1265699300
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Entity Type | Individual
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Provider Name | JAN HELEN ROY PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 875 NORTH MICHIGAN AVENUE SUITE 3710
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 847-989-0762
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Fax | 847-256-7126
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Provider Business Mailing Address
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Address Line | 3009 INDIANWOOD ROAD
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City | WILMETTE
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State | IL
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Zip | 60091
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Country | US
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Telephone | 847-256-7126
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Fax | 847-256-7126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071007334
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License Number State | IL
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