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General NPI Number Information
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NPI Number | 1699626598
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Entity Type | Organization
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Legal Business Name | EVERWELL THERAPY CHICAGO PLLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 6700 S CRANDON AVE APT 9C
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City | CHICAGO
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State | IL
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Zip | 60649-1270
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Country | US
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Telephone | 773-280-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 S CRANDON AVE APT 9C
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City | CHICAGO
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State | IL
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Zip | 60649-1270
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Country | US
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Telephone | 773-280-8883
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | JESSICA GENTRY
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Credential | LCPC
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Telephone | 970-581-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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