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General NPI Number Information
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NPI Number | 1427769306
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Entity Type | Individual
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Provider Name | JESSICA SAMPERIO MSW, LCSW, PEL
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Gender | Female
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 1816 W CHASE AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60626-2384
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Country | US
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Telephone | 312-552-3173
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 W CHASE AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60626-2384
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Country | US
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Telephone | 312-523-1730
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 2570197
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149023478
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License Number State | IL
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