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Organization

JESSICA LOFTUS, PH.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA LOFTUS (LICENSED CLINICAL PSYCHOLOGIST)
(708) 448-1306
Entity
Organization

Contact information

Practice address
7250 W COLLEGE DR, #1W, PALOS HEIGHTS, IL 60463-1151
(708) 448-1306
Mailing address
7250 W COLLEGE DR, #1W, PALOS HEIGHTS, IL 60463-1151

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005326
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1622293
BLUE CROSS BLUE SHIELD
IL
01
453170
MEDICARE ID-TYPE UNSPECIFIED
IL
Enumeration date
03/22/2014
Last updated
03/22/2014
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