Provider Demographics
NPI:1275050585
Name:GARMAN, JAMIE (LCGC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GARMAN
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 N DAMEN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5550
Mailing Address - Country:US
Mailing Address - Phone:847-533-6653
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE RM 2656
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-6854
Practice Address - Fax:708-216-5150
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL247.000097170300000X
IL246000366170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS