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Individual

DR. JASON J. WASHBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., ABPP

Contact information

Practice address
3047 N LINCOLN AVE, SUITE #400, CHICAGO, IL 60657-4999
(773) 904-0445
Mailing address
3047 N LINCOLN AVE, SUITE #400, CHICAGO, IL 60657-4999
(773) 904-0445

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071006568
IL
103T00000X
Psychologist
071006568
IL
103TB0200X
Cognitive & Behavioral Psychologist
071006568
IL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
071006568
IL

Other

Enumeration date
04/18/2007
Last updated
07/09/2011
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