Provider Demographics
NPI:1467187484
Name:JOBE, JEREMIAH (MSW,LSW)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:JOBE
Suffix:
Gender:M
Credentials:MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16151 WEBER RD # LL10
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0863
Mailing Address - Country:US
Mailing Address - Phone:815-782-8263
Mailing Address - Fax:
Practice Address - Street 1:16151 WEBER RD # LL10
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-0863
Practice Address - Country:US
Practice Address - Phone:815-782-8263
Practice Address - Fax:815-556-8140
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150108437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker