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General NPI Number Information
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NPI Number | 1417476599
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Entity Type | Organization
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Legal Business Name | CHICAGO TESTPREP.ORG, LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1220 N HOYNE AVE STE B
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City | CHICAGO
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State | IL
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Zip | 60622-3190
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Country | US
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Telephone | 773-360-8852
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Fax | 773-347-1777
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Provider Business Mailing Address
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Address Line | 1220 N HOYNE AVE STE B
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City | CHICAGO
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State | IL
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Zip | 60622-3190
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Country | US
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Telephone | 773-360-8852
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Fax | 773-347-1777
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Authorized Official
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Title or Position | COO/CHIEF PSYCHOLOGIST
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Name | DR. JOHN W JONES
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Credential | PH.D
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Telephone | 773-360-8852
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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 | 071.002712
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.002142
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License Number State | IL
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