Provider Demographics
NPI:1881832905
Name:CHILES, DEBORAH JEAN (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JEAN
Last Name:CHILES
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2809
Mailing Address - Country:US
Mailing Address - Phone:708-510-4755
Mailing Address - Fax:469-621-8190
Practice Address - Street 1:4137 SAUK TRL
Practice Address - Street 2:STE 127
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1253
Practice Address - Country:US
Practice Address - Phone:630-506-6321
Practice Address - Fax:972-323-7621
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist