Individual
JACQUELINE OLUWAKEMI MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
74 E. 47TH ST, CHICAGO, IL 60653
(773) 974-1547
Mailing address
74 E 47TH STREET, CHICAGO, IL 60653
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071011251
IL
Other
Enumeration date
08/16/2020
Last updated
02/13/2026
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