Gibson, Jennifer L

Gibson, Jennifer L is an sole proprietor health care provider with primary practice located at 2650 W Montrose Ave Suite 200, Chicago IL 60618-1560. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Gibson, Jennifer L can be contacted via phone (872) 205-6110.

Contact Information

Primary practice address
2650 W Montrose Ave Suite 200 Chicago IL 60618-1560
Phone: (872) 205-6110
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-007651 Illinois
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 071-007651 Illinois
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 071-007651 Illinois
Behavioral Health & Social Service Providers / Family 103TF0000X 071-007651 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071007651 Illinois

Profile Details

NPI number 1164544839
LBN Legal business name Gibson, Jennifer L
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2007
Last updated Oct 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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