Individual
DR. BRYN W JESSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
778 W FRONTAGE RD, 114, NORTHFIELD, IL 60093-1209
(847) 501-5897
(847) 501-5896
Mailing address
778 W FRONTAGE RD, 114, NORTHFIELD, IL 60093-1209
(847) 501-5897
(847) 501-5896
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003787
IL
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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