Individual
ANDREA JENELL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9542 S GREEN ST, CHICAGO, IL 60643-1506
(773) 603-2974
Mailing address
9542 S GREEN ST, CHICAGO, IL 60643-1506
(773) 603-2974
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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