Logston, Jennifer Keely
Logston, Jennifer Keely is an sole proprietor health care provider with primary practice located at 5010 Fairview Ave Ste 5 , Downers Grove IL 60515-5201. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Logston, Jennifer Keely can be contacted via phone (630) 528-8855.Contact Information
Primary practice address
5010 Fairview Ave Ste 5
Downers Grove IL 60515-5201
Phone: (630) 528-8855
Fax: (630) 541-6557
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149008632 | Illinois |
Profile Details
NPI number | 1841304094 |
---|---|
LBN Legal business name | Logston, Jennifer Keely |
Credentials | MSW, LCSW |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 17th, 2006 |
Last updated | Jan 28th, 2023 - about 2 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 | 1841304094 | NPPES |
Illinois | Other | 0002225381 | BLUE CROSS BLUE SHIELD |
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