Individual
ALAN M JAFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 1206, CHICAGO, IL 60602-3402
(312) 346-2640
Mailing address
30 N MICHIGAN AVE, CHICAGO, IL 60602-3727
(312) 346-2640
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
J10001352304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01672615
BLUE SHIELD PROVIDER NUMB
IL
Enumeration date
06/28/2006
Last updated
07/08/2007
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