Individual
DR. JASON RYAN SOBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., ABPP
Contact information
Practice address
912 S WOOD ST # MC913, CHICAGO, IL 60612-4300
(312) 996-6217
Mailing address
UNIVERSITY OF ILLINOIS AT CHICAGO-DEPT. OF PSYCHIATRY, 912 S. WOOD STREET, MC 913, CHICAGO, IL 60612-4300
(312) 996-6217
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071.009609
IL
103TC0700X
Clinical Psychologist
071.009609
IL
Other
Enumeration date
04/10/2014
Last updated
05/15/2024
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