Jenine Lee Chiles, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-006017 Issued in IL

Practice address

641 W 63Rd St
Specialty Clinic, Lower Level
Chicago, IL 60621-2032

Phone

(312) 745-0662

Fax

(312) 747-5275

NPI assigned

May 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316168412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 W SUPERIOR ST",
            "address_2": "APT. #1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121110",
            "telephone_number": "773-252-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "address_2": "SPECIALTY CLINIC, LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "312-745-0662",
            "fax_number": "312-747-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILES",
        "first_name": "JENINE",
        "middle_name": "LEE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Childress, PA-C
• Steven L Childrey
• Janna Lee Childs, LMT
• Milton Lee Childs Jr., PHARMD
• Olivia Childs, DO
• Richard A Chilton Jr., MSW, MPH
• Akanksha Chilukuri, MD
• Tiffany Chimaroke
• Chinecherem Chime-Eze, MD
• Chimera Health PLLC

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.