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General NPI Number Information
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NPI Number | 1407761232
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Entity Type | Individual
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Provider Name | JESSICA SHIMP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 1100 LAKE ST STE LL65
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City | OAK PARK
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State | IL
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Zip | 60301-1015
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Country | US
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Telephone | 708-620-2373
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Fax |
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Provider Business Mailing Address
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Address Line | 2529 W MEDILL AVE APT G
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City | CHICAGO
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State | IL
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Zip | 60647-3570
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Country | US
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Telephone | 847-909-6185
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 20326
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License Number State | IL
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