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NPI Code Detail

MEDICARE: JENNIFER LYNN ROOK MT-BC, LPC

MEDICARE: JENNIFER LYNN ROOK MT-BC, LPC
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
1225A00000XMusic Therapist
2101YP2500XProfessional Counselor178.007306IL

General Provider Information

NPI Number : 1912118738
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN ROOK MT-BC, LPC
Provider Business Mailing Address
First Line : 4951 134TH PL APT 3B
Second Line :
City : CRESTWOOD
State : IL
Zip : 60445-1444
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2008 DEMPSTER ST
Second Line :
City : EVANSTON
State : IL
Zip : 60202-1017
Country : US
Telephone Number : 847-448-8341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 01/14/2013

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