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General NPI Number Information
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NPI Number | 1881244150
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Entity Type | Individual
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Provider Name | STEVEN L JENNINGS JR. M.A.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 2950 W CHICAGO AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60622-4377
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Country | US
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Telephone | 312-625-6604
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 W CHICAGO AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60622-4377
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Country | US
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Telephone | 312-625-6604
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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