Organization
PSYCHOLOGY CENTER P.C.
Active
Other names
Psychology Center Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES T DAVENPORT PSY D (OWNER/PROVIDER)
(708) 974-4274
Entity
Organization
Contact information
Practice address
10343 S WESTERN AVENUE, CHICAGO, IL 60643-2410
(773) 238-2828
(708) 974-3845
Mailing address
10713 W DORIC CIRCLE, PALOS HILLS, IL 60465-2220
(773) 238-2828
(708) 974-3845
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
060005211
IL
103TC0700X
Clinical Psychologist
Primary
071003666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345365834001
—
IL
Enumeration date
10/21/2005
Last updated
01/28/2015
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