Provider Demographics
NPI:1225210974
Name:JAMES M. DOD, PH.D. LTD
Entity Type:Organization
Organization Name:JAMES M. DOD, PH.D. LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-480-1341
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209429Medicare UPIN