Individual
DR. KYLE JOSEPH JENNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-0123
Mailing address
51 E 14TH ST APT 710, CHICAGO, IL 60605-2980
(352) 634-1848
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071.010665
IL
103T00000X
Psychologist
071.010665
IL
103TC0700X
Clinical Psychologist
Primary
071.010665
IL
Other
Enumeration date
03/31/2022
Last updated
05/27/2024
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