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Organization

HARRY KENT PHD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HARRY MASON KENT PHD (PRESIDENT)
(773) 398-2415
Entity
Organization

Contact information

Practice address
77 N AIRLITE STREET, PROVENA ST JOSEPH HOSPITAL, ELGIN, IL 60123-4912
(847) 695-3200
(947) 622-3470
Mailing address
3540 N SOUTHPORT, #272, CHICAGO, IL 60657
(773) 398-2415

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04532067
BCBS
Enumeration date
11/21/2005
Last updated
08/22/2020
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