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General NPI Number Information
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NPI Number | 1124533708
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Entity Type | Individual
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Provider Name | JESSICA WONE LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60601-7401
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Country | US
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Telephone | 888-726-7170
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Fax |
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Provider Business Mailing Address
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Address Line | 85 S 3RD AVE
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City | LOMBARD
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State | IL
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Zip | 60148-3134
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Country | US
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Telephone | 732-710-0024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149023926
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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