Individual
JACOB RYAN BORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
3100 DUNDEE RD STE 101, NORTHBROOK, IL 60062-2462
(847) 919-9096
Mailing address
4431 N RACINE AVE APT 3S, CHICAGO, IL 60640-5661
(701) 205-9327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.019722
IL
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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