Provider Demographics
NPI:1821112897
Name:ENGLISH, JAMES MICHAEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:ENGLISH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:574 PICCADILLY LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1020
Mailing Address - Country:US
Mailing Address - Phone:630-452-0112
Mailing Address - Fax:630-910-1431
Practice Address - Street 1:1000 MAPLE AVE
Practice Address - Street 2:MAIN FLOOR
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515
Practice Address - Country:US
Practice Address - Phone:630-452-0112
Practice Address - Fax:630-910-1431
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002227907Medicare UPIN