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Organization

JENNIFER GIBSON, PSYD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER GIBSON PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(312) 316-5551
Entity
Organization

Contact information

Practice address
2650 W MONTROSE AVE, SUITE 200, CHICAGO, IL 60618-1560
(872) 205-6110
Mailing address
4334 N BELL AVE, CHICAGO, IL 60618-1610
(312) 316-5551

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007651
IL

Other

Enumeration date
10/28/2014
Last updated
10/28/2014
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