Healthcare Provider Details

I. General information

NPI: 1861341026
Provider Name (Legal Business Name): JEANNE MARIE CLEMMER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 S ROBERTS RD STE 102
PALOS HILLS IL
60465-1556
US

IV. Provider business mailing address

10101 S ROBERTS RD STE 102
PALOS HILLS IL
60465-1556
US

V. Phone/Fax

Practice location:
  • Phone: 630-436-9210
  • Fax:
Mailing address:
  • Phone: 630-426-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number150.118826
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: