Provider Demographics
NPI:1407231939
Name:ROWEN, JENNA (PHD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ROWEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 W MONROE ST
Mailing Address - Street 2:SUITE 229
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-4910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:73 W MONROE ST
Practice Address - Street 2:SUITE 229
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-4910
Practice Address - Country:US
Practice Address - Phone:312-413-8709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009456103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical