| Jennifer Booth Psyd Pllc | |
|
1409 W Irving Park Rd Chicago IL 60613-1920 | |
| (224) 636-4942 | |
| Not Available |
| Full Name | Jennifer Booth Psyd Pllc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1409 W Irving Park Rd, Chicago, Illinois |
| Authorized Official Name and Position | Jennifer L Corley (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2246364942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Booth Psyd Pllc 1929 W Henderson St Rear Chicago IL 60657-6666 Ph: (224) 636-4942 | Jennifer Booth Psyd Pllc 1409 W Irving Park Rd Chicago IL 60613-1920 Ph: (224) 636-4942 |
| NPI Number | 1417643503 |
|---|---|
| Provider Enumeration Date | 04/12/2023 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417643503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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