Owens, Jesse Lee

Owens, Jesse Lee is an sole proprietor health care provider with primary practice located at 15475 S Park Ave Ste 102 , South Holland IL 60473-1378. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Owens, Jesse Lee can be contacted via phone (312) 480-5775.

Contact Information

Primary practice address
15475 S Park Ave Ste 102 South Holland IL 60473-1378
Phone: (312) 480-5775
Fax: (312) 436-5208
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149-007440 Illinois

Profile Details

NPI number 1871586214
LBN Legal business name Owens, Jesse Lee
Credentials M.A, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2005
Last updated Oct 10th, 2017 - about 7 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 1871586214 NPPES
Illinois Other 01634638 BCBS OF ILLINOIS
Illinois Other 810323000 BCBS OF ILLINOIS

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