Individual
JENINE LEE CHILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
641 W 63RD ST, SPECIALTY CLINIC, LOWER LEVEL, CHICAGO, IL 60621-2032
(312) 745-0662
(312) 747-5275
Mailing address
2613 W SUPERIOR ST, APT. #1, CHICAGO, IL 60612-1110
(773) 252-7199
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006017
IL
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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