MEDICARE: MARSHALL PSYCHOTHERAPY PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1972448231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSHALL PSYCHOTHERAPY PLLC

Provider Business Mailing Address
First Line	:	1744 N WESTERN AVE APT 202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6263
Country	:	US
Telephone Number	:	630-723-7997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1744 N WESTERN AVE APT 202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6263
Country	:	US
Telephone Number	:	630-723-7997
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND PSYCHOTHERAPIST
Name	:	JANE MARSHALL KEMP
Credential	:
Telephone Number	:	630-723-7997

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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