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General NPI Number Information
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NPI Number | 1881832905
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Entity Type | Individual
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Provider Name | DEBORAH JEAN CHILES PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 4137 SAUK TRL STE 127
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City | RICHTON PARK
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State | IL
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Zip | 60471-1253
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Country | US
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Telephone | 630-506-6321
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Fax | 972-323-7621
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Provider Business Mailing Address
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Address Line | 4325 MAPLE AVE
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City | MATTESON
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State | IL
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Zip | 60443-2809
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Country | US
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Telephone | 708-510-4755
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Fax | 469-621-8190
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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 | 071007594
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License Number State | IL
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