Provider Demographics
NPI:1073673000
Name:SITTIG, JESSICA BETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:BETH
Last Name:SITTIG
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7243 MADISON ST
Mailing Address - Street 2:416
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-3726
Mailing Address - Country:US
Mailing Address - Phone:708-289-3017
Mailing Address - Fax:
Practice Address - Street 1:7243 MADISON ST
Practice Address - Street 2:416
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-3726
Practice Address - Country:US
Practice Address - Phone:708-289-3017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490101711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical