Jennings, Carol Dianne
Jennings, Carol Dianne is an individual health care provider with primary practice located at 708 Church Street Suite 245, Evanston IL 60201-3840. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jennings, Carol Dianne can be contacted via phone (847) 492-9288.Contact Information
Primary practice address
708 Church Street Suite 245
Evanston IL 60201-3840
Phone: (847) 492-9288
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | Illinois |
Profile Details
| NPI number | 1265577662 |
|---|---|
| LBN Legal business name | Jennings, Carol Dianne |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265577662 | NPPES |
| Illinois | Other | 01634922 | BLUE CROSS BLUE SHIELD |
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