Provider Demographics
NPI:1659809606
Name:BYRNE, JENNIFER DELORY (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DELORY
Last Name:BYRNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR STE 800
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8701
Mailing Address - Country:US
Mailing Address - Phone:312-642-7230
Mailing Address - Fax:312-642-7005
Practice Address - Street 1:4250 N MARINE DR APT 2323
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1747
Practice Address - Country:US
Practice Address - Phone:773-386-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150101440104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker