MEDICARE: JENNIFER DURAN LSW

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	104100000X	Social Worker	150.103377	IL
2	1041C0700X	Clinical Social Worker	149-023445	IL

General Provider Information

NPI Number	:	1679046502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DURAN LSW

Provider Business Mailing Address
First Line	:	120 S MARION ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2809
Country	:	US
Telephone Number	:	708-383-7500
Fax Number	:	708-383-7780

Provider Business Practice Location Address
First Line	:	120 S MARION ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2809
Country	:	US
Telephone Number	:	708-383-7500
Fax Number	:	708-383-7780

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

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	12/09/2025

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