Organization
JANE E. SAMUELSON, PHD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANE E. SAMUELSON PHD (OWNER/PROVIDER)
(708) 524-1267
Entity
Organization
Contact information
Practice address
111 NORTH WABASH, SUITE 1704, CHICAGO, IL 60602-1900
(708) 524-1267
Mailing address
111 NORTH WABASH, SUITE 1704, CHICAGO, IL 60602-1900
(708) 524-1267
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-003172
IL
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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