Larson, Jeffrey Gerard

Larson, Jeffrey Gerard is an individual health care provider with primary practice located at 451 Dunham Rd Suite 400, Saint Charles IL 60174-1431. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Larson, Jeffrey Gerard can be contacted via phone (630) 444-1801.

Contact Information

Primary practice address
451 Dunham Rd Suite 400 Saint Charles IL 60174-1431
Phone: (630) 444-1801
Fax: (630) 444-0494
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149012296 Illinois

Profile Details

NPI number 1154657245
LBN Legal business name Larson, Jeffrey Gerard
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2009
Last updated Oct 23rd, 2009 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1154657245 NPPES
Illinois Other 1235255993 NPI
Illinois Other 149012296 NPI

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