Individual
JAY LEBOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
618 LIBRARY PL, EVANSTON, IL 60201-2908
(847) 733-4300
(847) 328-1796
Mailing address
931 MAPLE AVE, EVANSTON, IL 60202-1717
(847) 612-2339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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