Healthcare Provider Details

I. General information

NPI: 1346137080
Provider Name (Legal Business Name): JENNIFER ESPINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 AUSTIN ST # 312
EVANSTON IL
60202-3439
US

IV. Provider business mailing address

800 AUSTIN ST # 312
EVANSTON IL
60202-3439
US

V. Phone/Fax

Practice location:
  • Phone: 847-224-7670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: