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General NPI Number Information
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NPI Number | 1851716047
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Entity Type | Individual
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Provider Name | KENNETH WILLIAM JAMES PH.D., I.A.A.P.
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Gender | Male
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 124 W POLK ST 101
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City | CHICAGO
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State | IL
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Zip | 60605-1784
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Country | US
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Telephone | 773-983-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 47 W POLK ST STE 100-174
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City | CHICAGO
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State | IL
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Zip | 60605-2000
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Country | US
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Telephone | 773-983-5448
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180001219
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 180001219
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License Number State | IL
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