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NPI Code Detail

MEDICARE: DR. JENNIFER MICHELLE HARRIS PSY.D

MEDICARE:  DR. JENNIFER MICHELLE HARRIS  PSY.D
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
1103TC0700XClinical Psychologist071009257IL

General Provider Information

NPI Number : 1881055499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER MICHELLE HARRIS PSY.D
Provider Business Mailing Address
First Line : 336 LATROBE AVE
Second Line :
City : NORTHFIELD
State : IL
Zip : 60093-3519
Country : US
Telephone Number : 847-414-5656
Fax Number :
Provider Business Practice Location Address
First Line : 2000 N RACINE AVE STE 2190
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7007
Country : US
Telephone Number : 847-414-5656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2016
Last Update Date : 08/03/2022

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Directions to “ DR. JENNIFER MICHELLE HARRIS PSY.D” Practice Location

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