Individual
DR. SHAWN DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
456 CENTRAL AVENUE, 201, NORTHFIELD, IL 60093
(773) 852-9869
Mailing address
1750 W JULIAN ST, #4, CHICAGO, IL 60622-2110
(773) 852-9869
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071006371
IL
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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