Provider Demographics
NPI:1700251519
Name:OKOON PSYCHOLOGY GROUP PC
Entity Type:Organization
Organization Name:OKOON PSYCHOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KOON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-729-5510
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:847-729-5512
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006294103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty