MEDICARE: HAMMER MENTAL HEALTH, INC.

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	103TC0700X	Clinical Psychologist	071.008559	IL

General Provider Information

NPI Number	:	1629590203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMMER MENTAL HEALTH, INC.

Provider Business Mailing Address
First Line	:	641 NOR OAKS CT
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2000
Country	:	US
Telephone Number	:	630-415-6215
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 W WASHINGTON ST STE A
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2803
Country	:	US
Telephone Number	:	630-415-6215
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	JANELLE HAMMER
Credential	:	PSY.D.
Telephone Number	:	630-415-6215

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	07/14/2017

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