MEDICARE: JESSICA SPRINGER

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1346058831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SPRINGER

Provider Business Mailing Address
First Line	:	4609 N ROCKWELL ST APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 N RAVENSWOOD AVE STE 105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-7569
Country	:	US
Telephone Number	:	847-906-3407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	12/30/2024

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Directions to “ JESSICA SPRINGER ” Practice Location

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