KATHRYN B JACK LCPC NPI 1083768642

NPI Information

NPI: 1083768642
Provider Name: KATHRYN B JACK, LCPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
490 E ROOSEVELT RD STE 205
WEST CHICAGO, IL
ZIP 60185
Phone: (630) 779-0972
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Kathryn B Jack, LCPC is a mental health counselor in West Chicago, IL. Kathryn B Jack, LCPC NPI is 1083768642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

490 E ROOSEVELT RD STE 205
WEST CHICAGO, IL
ZIP 60185-901
Phone: (630) 779-0972

The enumeration date for this NPI number is 1/22/2007 and was last updated on 12/20/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	180005428	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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