Individual
JACKIE GOLLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
446 E ONTARIO ST, SUITE 7-100, CHICAGO, IL 60611-4418
(312) 695-5060
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
(312) 695-9797
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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