Individual
DR. JENNY H CONVISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1161 LONGMEADOW LN, GLENCOE, IL 60022-1064
(773) 551-7746
Mailing address
1161 LONGMEADOW LN, GLENCOE, IL 60022-1064
(773) 551-7746
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.004492
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071.004492
STATE LICENSE NO
IL
01
—
1607378
BCBS PROVIDER NUMBER
IL
Enumeration date
05/14/2007
Last updated
11/19/2025
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