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Individual

DR. JANE DOROTHY CONRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
122 S MICHIGAN AVE, #1025, CHICAGO, IL 60603-6191
(773) 859-1718
Mailing address
6007 N SHERIDAN RD, #26E, CHICAGO, IL 60660-3039
(773) 293-3835

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01622678
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/04/2007
Last updated
07/08/2007
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