Provider Demographics
NPI:1255348777
Name:KOWAL, JAMES ALLEN (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:KOWAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1220 HOBSON RD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8139
Mailing Address - Country:US
Mailing Address - Phone:630-637-4002
Mailing Address - Fax:630-637-4002
Practice Address - Street 1:1220 HOBSON RD
Practice Address - Street 2:SUITE 232
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8139
Practice Address - Country:US
Practice Address - Phone:630-637-4002
Practice Address - Fax:630-637-4002
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL180-003245103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2223237OtherBCBS