Individual
JESSICA LANE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 S PROMONTORY DR # 1003, CHICAGO, IL 60649-1002
(773) 256-5788
Mailing address
948 W 31ST PL, CHICAGO, IL 60608-6612
(480) 244-2144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005307
IL
224Z00000X
Occupational Therapy Assistant
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
03/10/2016
Last updated
02/20/2026
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