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Individual

JACQUES D BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
1525 E 53RD ST STE 901, CHICAGO, IL 60615-4572
(773) 234-0644
Mailing address
1403 E EVERGREEN DR APT 101, PALATINE, IL 60074-8712
(574) 315-0546

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
03/07/2024
Last updated
09/11/2025
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