Individual
DR. JASON CHARLES KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1599 MAPLE AVE, EVANSTON, IL 60201-4367
(708) 699-1670
(847) 570-6083
Mailing address
1137 MAPLE AVE, 2E, EVANSTON, IL 60202-1262
(708) 699-1670
(847) 570-6083
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007455
IL
Other
Enumeration date
05/05/2008
Last updated
08/18/2008
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