Provider Demographics
NPI:1497818892
Name:DEWITT, PATRICIA H (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:H
Last Name:DEWITT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3007
Mailing Address - Country:US
Mailing Address - Phone:847-382-5688
Mailing Address - Fax:847-382-5697
Practice Address - Street 1:130 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3007
Practice Address - Country:US
Practice Address - Phone:847-382-5688
Practice Address - Fax:847-382-5697
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical