Individual
JENELLE NICOLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1142 W MADISON ST, CHICAGO, IL 60607-2191
(312) 324-4502
Mailing address
15255 S 94TH AVE STE 500, SUITE 500 - #365, ORLAND PARK, IL 60462
(773) 273-6365
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102988
IL
Other
Enumeration date
10/22/2019
Last updated
04/04/2021
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