Individual
JENAE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 W GREENLEAF AVE, CHICAGO, IL 60626-2805
(773) 508-6100
Mailing address
1400 W GREENLEAF AVE, CHICAGO, IL 60626-2805
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.012322
IL
Other
Enumeration date
05/26/2020
Last updated
01/30/2023
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