Provider Information for 1902418486
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Mrs. JENNIFER ELIZABETH CHICOINE M.A., LCPC, CCTP
Sex: Female
NPI: 1902418486
Last Updated: 2024-01-15
Certification Date: 2024-01-15
Certification Date: 2024-01-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1902418486 | ||||||||
| Enumeration Date | 2020-08-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 15010 S RAVINIA AVE STE 12 ORLAND PARK, IL 60462-5353 United States Phone: 708-971-0470 | Fax:708-590-6573 | ||||||||
| Primary Practice Address | 15010 S RAVINIA AVE STE 12 ORLAND PARK, IL 60462-5353 United States Phone: 708-971-0470 | Fax: | ||||||||
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