Organization
JAMIE EDWARDS LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE EDWARDS LCSW (OWNER)
(224) 627-0534
Entity
Organization
Contact information
Practice address
1701 E LAKE AVE STE 255, GLENVIEW, IL 60025-2037
(847) 881-6870
Mailing address
9359 OSCEOLA AVE, MORTON GROVE, IL 60053-1127
(224) 627-0534
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295159283
NPI
—
Enumeration date
10/12/2018
Last updated
07/30/2023
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