| Jaclyn Ross Phd Pllc | |
|
53 W Jackson Blvd Ste 336 Chicago IL 60604-3688 | |
| (708) 665-4721 | |
| Not Available |
| Full Name | Jaclyn Ross Phd Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 53 W Jackson Blvd Ste 336, Chicago, Illinois |
| Authorized Official Name and Position | Jaclyn Ross (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3122100374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaclyn Ross Phd Pllc 2333 W Saint Paul Ave Apt 133 Chicago IL 60647-5343 Ph: (908) 246-5028 | Jaclyn Ross Phd Pllc 53 W Jackson Blvd Ste 336 Chicago IL 60604-3688 Ph: (708) 665-4721 |
| NPI Number | 1881455012 |
|---|---|
| Provider Enumeration Date | 01/16/2024 |
| Last Update Date | 01/16/2024 |
| Certification Date | 01/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881455012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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