James John Kotleba, LIC CLINICAL PSYCHOL

NPI #1164729620 in West Dundee, Illinois

Provider Information

NPI Number: 1164729620
Entity Type: Individual
Name: James John Kotleba, LIC CLINICAL PSYCHOL
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: LIC CLINICAL PSYCHOL
Enumeration Date: Feb 18, 2011
Last Updated: Dec 13, 2011

Practice Location

Address: 745 S 8TH ST
City: West Dundee
State: Illinois
ZIP Code: 60118-3602
Phone: (800) 428-7260

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X
Psychologist	103T00000X	Primary

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