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General NPI Number Information
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NPI Number | 1447900212
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Entity Type | Individual
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Provider Name | CHANA JAKOFSKY
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Gender | Female
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 4433 W TOUHY AVE STE 335
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1820
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Country | US
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Telephone | 877-486-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 2926 W FITCH AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2936
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-206777
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 1-23-69902
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-69902
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License Number State | IL
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