Individual
DR. JANE ELLEN SAMUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH. D.
Contact information
Practice address
111 N WABASH AVE, SUITE 1704, CHICAGO, IL 60602-1903
(708) 524-1267
Mailing address
208 S MAPLE AVE, APT. 19, OAK PARK, IL 60302-3028
(708) 524-1267
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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