Provider Demographics
NPI:1598488736
Name:VICTOR, CONSTANCE RHODES (PSYD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:RHODES
Last Name:VICTOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N MICHIGAN AVE STE 707
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7706
Mailing Address - Country:US
Mailing Address - Phone:312-600-8310
Mailing Address - Fax:312-610-5630
Practice Address - Street 1:155 N MICHIGAN AVE STE 707
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7706
Practice Address - Country:US
Practice Address - Phone:312-600-8310
Practice Address - Fax:312-610-5630
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist