Provider Demographics
NPI:1083137905
Name:VOLLMAN, JENNIFER DANIELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DANIELLE
Last Name:VOLLMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S LOMBARD AVE APT A
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3367
Mailing Address - Country:US
Mailing Address - Phone:708-837-8896
Mailing Address - Fax:
Practice Address - Street 1:205 S LOMBARD AVE APT A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-3367
Practice Address - Country:US
Practice Address - Phone:708-837-8813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.011167103T00000X
IL27-2165595390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist