Provider Demographics
NPI:1629258926
Name:O'KOON, JEFFREY H (PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:O'KOON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 PATRIOT BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8021
Mailing Address - Country:US
Mailing Address - Phone:847-729-5510
Mailing Address - Fax:847-657-9815
Practice Address - Street 1:2700 PATRIOT BLVD STE 240
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8021
Practice Address - Country:US
Practice Address - Phone:847-729-5510
Practice Address - Fax:847-729-5512
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006294103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist