Individual
DR. JACQUELINE E. GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(205) 329-0892
Mailing address
5841 S MARYLAND AVE RM J-141, CHICAGO, IL 60637-1443
(205) 329-0892
(888) 524-8166
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
168646
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
06/25/2024
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