Provider Demographics
NPI:1003123324
Name:WATSON, JAMES J (HIS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:WATSON
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6026
Mailing Address - Country:US
Mailing Address - Phone:847-222-9687
Mailing Address - Fax:847-222-9686
Practice Address - Street 1:214 E NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-6026
Practice Address - Country:US
Practice Address - Phone:847-222-9687
Practice Address - Fax:847-222-9686
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2905237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist