Individual
DR. COLIN ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
53 W JACKSON BLVD, 635, CHICAGO, IL 60604-3606
(312) 725-9745
(312) 488-3642
Mailing address
3450 N LAKE SHORE DR, 515, CHICAGO, IL 60657-2874
(312) 725-9745
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008031
IL
Other
Enumeration date
12/02/2010
Last updated
08/13/2014
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