MEDICARE: JENNIFER COX LCPC

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	101YP2500X	Professional Counselor	180.011082	IL

General Provider Information

NPI Number	:	1649535873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER COX LCPC

Provider Business Mailing Address
First Line	:	44 N VIRGINIA ST STE 3B
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-4154
Country	:	US
Telephone Number	:	815-363-0864
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 N VIRGINIA ST STE 3B
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-4154
Country	:	US
Telephone Number	:	815-363-0864
Fax Number	:

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

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	02/27/2024

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