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General NPI Number Information
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NPI Number | 1780495986
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Entity Type | Individual
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Provider Name | KATHRYN CLAIRE JABLONSKY MED
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 2750 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60608-1048
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Country | US
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Telephone | 773-435-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 W ADAMS ST UNIT 425
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City | CHICAGO
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State | IL
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Zip | 60607-3092
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Country | US
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Telephone | 815-321-3930
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 178.020348
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License Number State | IL
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