Holdeman, Jason Todd

Holdeman, Jason Todd is an sole proprietor health care provider with primary practice located at 3420 Illinois St , Great Lakes IL 60088-3161. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Holdeman, Jason Todd can be contacted via phone (847) 688-6755.

Contact Information

Primary practice address
3420 Illinois St Great Lakes IL 60088-3161
Phone: (847) 688-6755
Fax: (847) 688-7411
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20041693A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-006876 Illinois

Profile Details

NPI number 1952385148
LBN Legal business name Holdeman, Jason Todd
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2005
Last updated May 31st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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