Most Relevant Information
Provider Data
| NPI Number: | 1003263112 |
| Provider Name: | RAE WATKINS PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 071009266 |
Most Important Dates
| Enumeration Date: | 05/18/2016 |
| Last Updated: | 02/28/2023 |
Provider Practice Location
1519 W IRVING PARK RD STE 1
CHICAGO
IL
606132549
Practice Location Phone/Fax
| Phone: | 7736007580 |
| Fax: |
Provider Mailing Location
PO BOX 180051
CHICAGO
IL
606180025
Provider Mailing Phone/Fax
| Phone: | 7736007580 |
| Fax: |