Provider Demographics
NPI:1659648103
Name:LEIGHTON, JESSICA CLAIRE (MSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:CLAIRE
Last Name:LEIGHTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 CLYBOURN AVE.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4946
Mailing Address - Country:US
Mailing Address - Phone:773-305-5000
Mailing Address - Fax:773-305-0739
Practice Address - Street 1:1925 N CLYBOURN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4946
Practice Address - Country:US
Practice Address - Phone:773-305-5000
Practice Address - Fax:773-305-0739
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities