Provider Demographics
NPI:1639841059
Name:BIGGOTT, JACLYN RENEE (MA)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:RENEE
Last Name:BIGGOTT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3203
Mailing Address - Country:US
Mailing Address - Phone:630-945-5052
Mailing Address - Fax:
Practice Address - Street 1:3295 N ARLINGTON HEIGHTS RD STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1588
Practice Address - Country:US
Practice Address - Phone:847-668-2842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional