Provider Information for 1124246871
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
JEAN K TIERNAN LCSW, CADC
Sex: Female
NPI: 1124246871
Last Updated: 2023-10-18
Certification Date: 2023-10-18
Certification Date: 2023-10-18
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124246871 | ||||||||||||||||
| Enumeration Date | 2007-04-20 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | PO BOX 115 SHINGLETON, MI 49884-0115 United States Phone: 847-894-4919 | Fax: | ||||||||||||||||
| Primary Practice Address | 1001 ROHLWING RD ELK GROVE VILLAGE, IL 60007-3217 United States Phone: 847-524-8800 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|