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NPI Code Detail

MEDICARE: JAMIE SANDOMIRE

MEDICARE: JAMIE SANDOMIRE
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1881443257
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE SANDOMIRE
Provider Business Mailing Address
First Line : 1925 N CLYBOURN AVE STE 401
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7397
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1925 N CLYBOURN AVE STE 401
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7397
Country : US
Telephone Number : 708-628-7579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2024
Last Update Date : 05/16/2024

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Directions to “ JAMIE SANDOMIRE ” Practice Location

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