MEDICARE: JESSICA LYNN GOOD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.031283	IL

General Provider Information

NPI Number	:	1437911310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYNN GOOD LCSW

Provider Business Mailing Address
First Line	:	1732 N KEDVALE AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-4936
Country	:	US
Telephone Number	:	815-545-6009
Fax Number	:

Provider Business Practice Location Address
First Line	:	2749 W 63RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2342
Country	:	US
Telephone Number	:	773-434-4626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2024
Last Update Date	:	03/13/2026

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