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General NPI Number Information
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NPI Number | 1376202804
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Entity Type | Organization
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Legal Business Name | CONNECTION WORKS, PLLC
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 350 S NORTHWEST HWY STE 300
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City | PARK RIDGE
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State | IL
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Zip | 60068-4262
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Country | US
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Telephone | 773-946-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 350 S NORTHWEST HWY STE 300
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City | PARK RIDGE
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State | IL
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Zip | 60068-4262
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Country | US
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Telephone | 773-946-0993
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/SOLE MEMBER
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Name | DR. SOFIA CARLEEN JIMENEZ
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Credential | PSYD
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Telephone | 773-946-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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