Healthcare Provider Details

I. General information

NPI: 1912118738
Provider Name (Legal Business Name): JENNIFER LYNN ROOK MT-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 DEMPSTER ST
EVANSTON IL
60202-1017
US

IV. Provider business mailing address

4951 134TH PL APT 3B
CRESTWOOD IL
60445-1444
US

V. Phone/Fax

Practice location:
  • Phone: 847-448-8341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.007306
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: