Healthcare Provider Details

I. General information

NPI: 1407578222
Provider Name (Legal Business Name): JENNIFER DORAN MA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 N ARLINGTON HEIGHTS RD STE E
ARLINGTON HEIGHTS IL
60004-1591
US

IV. Provider business mailing address

3345 N ARLINGTON HEIGHTS RD STE E
ARLINGTON HEIGHTS IL
60004-1591
US

V. Phone/Fax

Practice location:
  • Phone: 847-577-1501
  • Fax: 847-577-3858
Mailing address:
  • Phone: 847-577-1570
  • Fax: 847-577-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.018678
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: