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General NPI Number Information
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NPI Number | 1780342311
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Entity Type | Individual
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Provider Name | JASMINE BAGGETT
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Gender | Female
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 20015 S LAGRANGE RD
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City | FRANKFORT
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State | IL
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Zip | 60423-3104
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Country | US
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Telephone | 773-340-9622
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Fax |
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Provider Business Mailing Address
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Address Line | 6920 W 65TH ST APT 8
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City | BEDFORD PARK
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State | IL
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Zip | 60638-4675
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Country | US
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Telephone | 773-621-8135
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150107185
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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 | 149.025929
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License Number State | IL
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