Provider Demographics
NPI:1053465500
Name:DOD, JAMES M (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:DOD
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:1200 SHERMER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4500
Mailing Address - Country:US
Mailing Address - Phone:847-480-1341
Mailing Address - Fax:847-480-1348
Practice Address - Street 1:1200 SHERMER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4500
Practice Address - Country:US
Practice Address - Phone:847-480-1341
Practice Address - Fax:847-480-1348
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209429Medicare ID - Type Unspecified