Provider Demographics
NPI:1548501570
Name:DR. CONRON AND ASSOCIATES
Entity type:Organization
Organization Name:DR. CONRON AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST/OWNE
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONRON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-859-1718
Mailing Address - Street 1:625 N MICHIGAN AVE STE 1715
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3685
Mailing Address - Country:US
Mailing Address - Phone:773-859-1718
Mailing Address - Fax:
Practice Address - Street 1:625 N MICHIGAN AVE STE 1715
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3685
Practice Address - Country:US
Practice Address - Phone:773-859-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004750103TB0200X, 103TF0000X, 103TH0004X, 103TC0700X
IL071004570103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty