Provider Demographics
NPI:1497528962
Name:COMPTON, JAMELLA RASHEEN
Entity Type:Individual
Prefix:
First Name:JAMELLA
Middle Name:RASHEEN
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 W LINCOLN HWY APT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-2648
Mailing Address - Country:US
Mailing Address - Phone:708-595-4288
Mailing Address - Fax:
Practice Address - Street 1:148 W LINCOLN HWY APT 3W
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-2648
Practice Address - Country:US
Practice Address - Phone:708-595-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILC51343680865251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management