Provider Demographics
NPI:1659422939
Name:PATTON, JEANETTE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PHILIP DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1524
Mailing Address - Country:US
Mailing Address - Phone:630-853-1938
Mailing Address - Fax:630-372-5066
Practice Address - Street 1:1497 N LA FOX ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-1227
Practice Address - Country:US
Practice Address - Phone:630-853-1938
Practice Address - Fax:630-371-5066
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional