Individual
DR. JAMES KELLEY WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1653 W CONGRESS PKWY, SLEEP DISORDERS CENTER, RUSH UNIVERSITY MEDICAL CENTER, CHICAGO, IL 60612-3833
(312) 942-5440
(312) 942-8961
Mailing address
1653 W CONGRESS PKWY, SLEEP DISORDERS CENTER, RUSH UNIVERSITY MEDICAL CENTER, CHICAGO, IL 60612-3833
(312) 942-5440
(312) 942-8961
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071005918
IL
103TB0200X
Cognitive & Behavioral Psychologist
071005918
IL
103TC0700X
Clinical Psychologist
Primary
071005918
IL
103TH0004X
Health Psychologist
071005918
IL
Other
Enumeration date
01/12/2007
Last updated
04/06/2022
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