Provider Demographics
NPI:1780668939
Name:JANE V. DYONZAK, PH.D.
Entity type:Organization
Organization Name:JANE V. DYONZAK, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:V
Authorized Official - Last Name:DYONZAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-657-6007
Mailing Address - Street 1:3633 W LAKE AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5801
Mailing Address - Country:US
Mailing Address - Phone:847-657-6007
Mailing Address - Fax:847-657-6412
Practice Address - Street 1:3633 W LAKE AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5805
Practice Address - Country:US
Practice Address - Phone:847-657-6007
Practice Address - Fax:847-657-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004588103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty