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General NPI Number Information
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NPI Number | 1972058295
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Entity Type | Individual
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Provider Name | JENNIFER LEE BONINO SOBOL PH.D., LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 17 N DEARBORN ST FL 15
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City | CHICAGO
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State | IL
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Zip | 60602-4310
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Country | US
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Telephone | 312-583-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 WICKHAM CT
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City | NAPERVILLE
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State | IL
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Zip | 60540-8319
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Country | US
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Telephone | 312-583-7171
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-MH30730
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 39004877A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.011558
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License Number State | IL
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