Provider Demographics
NPI:1265699300
Name:ROY, JAN HELEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:HELEN
Last Name:ROY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:HELEN
Other - Last Name:FICKINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3009 INDIANWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091
Mailing Address - Country:US
Mailing Address - Phone:847-256-7126
Mailing Address - Fax:847-256-7126
Practice Address - Street 1:875 NORTH MICHIGAN AVENUE
Practice Address - Street 2:SUITE 3710
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:847-989-0762
Practice Address - Fax:847-256-7126
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist