Individual
MR. JAMES ADRIAN FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
122 S. PRAIRIE ST. SUITE A, ROCKTON, IL 61072
(815) 624-8383
(815) 624-8383
Mailing address
122 S. PRAIRIE ST SUITE A, ROCKTON, IL 61072
(815) 624-8383
(815) 624-8383
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-003-659
IL
103TC0700X
Clinical Psychologist
071.003659
IL
Other
Enumeration date
04/13/2011
Last updated
04/27/2016
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