Provider Demographics
NPI:1437316585
Name:CRISTERNA, JINNIE KWON (LCSW)
Entity Type:Individual
Prefix:
First Name:JINNIE
Middle Name:KWON
Last Name:CRISTERNA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12524 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-7231
Mailing Address - Country:US
Mailing Address - Phone:312-382-8710
Mailing Address - Fax:
Practice Address - Street 1:1750 E GOLF RD STE 395D
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5090
Practice Address - Country:US
Practice Address - Phone:312-382-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490095941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical