Provider Demographics
NPI:1013309426
Name:LE, DAVID XUAN-KHOA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:XUAN-KHOA
Last Name:LE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S MICHIGAN AVE STE 1007
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3453
Mailing Address - Country:US
Mailing Address - Phone:312-609-5300
Mailing Address - Fax:
Practice Address - Street 1:8 S MICHIGAN AVE STE 1007
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3453
Practice Address - Country:US
Practice Address - Phone:312-609-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-21
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
VA0810006361103T00000X
IL071009885103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist