Healthcare Provider Details

I. General information

NPI: 1831502749
Provider Name (Legal Business Name): JILLIAN MCNAMARA LPC, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N WASHINGTON ST STE 150
NAPERVILLE IL
60540
US

IV. Provider business mailing address

121 N WASHINGTON ST STE 150
NAPERVILLE IL
60540-4559
US

V. Phone/Fax

Practice location:
  • Phone: 630-267-4288
  • Fax:
Mailing address:
  • Phone: 630-640-5013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178003553
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1908622
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: