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General NPI Number Information
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NPI Number | 1144850256
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Entity Type | Individual
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Provider Name | JENNIFER NGAONYE
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Gender | Female
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 9522 S HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60628-1028
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Country | US
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Telephone | 773-595-5794
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Fax |
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Provider Business Mailing Address
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Address Line | 5155 W WASHINGTON BLVD FL 1
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City | CHICAGO
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State | IL
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Zip | 60644-3441
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Country | US
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Telephone | 773-425-9986
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178015634
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License Number State | IL
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