Individual
DR. JENNIFER L GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
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
103TB0200X
Cognitive & Behavioral Psychologist
071-007651
IL
103TC0700X
Clinical Psychologist
Primary
071-007651
IL
103TC0700X
Clinical Psychologist
071007651
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071-007651
IL
103TF0000X
Family Psychologist
071-007651
IL
Other
Enumeration date
04/04/2007
Last updated
10/13/2014
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