MEDICARE: JENNIFER L FARRELL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	180.006686	IL

General Provider Information

NPI Number	:	1104359611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER L FARRELL PLLC

Provider Business Mailing Address
First Line	:	755 N WILLIAMS DR
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60074-7270
Country	:	US
Telephone Number	:	773-895-3088
Fax Number	:

Provider Business Practice Location Address
First Line	:	4803 N MILWAUKEE AVE STE C1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2146
Country	:	US
Telephone Number	:	773-420-6960
Fax Number	:	847-496-7406

Authorized Official
Title or Position	:	MANAGING MEMBER/ THERAPIST
Name	:	JENNIFER FARRELL
Credential	:	LCPC, NCC, CEAP
Telephone Number	:	773-895-3088

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	05/19/2026

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