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Individual

DR. MICHAEL CHAMBERLAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
1025 W SUNNYSIDE AVE STE 100, CHICAGO, IL 60640-5684
(773) 388-1600
(773) 388-8936
Mailing address
6851 S EVANS AVE, CHICAGO, IL 60637-4118
(503) 312-1635

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010508
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071.010508
IL
Enumeration date
04/19/2021
Last updated
05/10/2022
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