Provider Demographics
NPI:1679061188
Name:JILLIAN CALIENDO PSYD INC
Entity Type:Organization
Organization Name:JILLIAN CALIENDO PSYD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIENDO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-985-6855
Mailing Address - Street 1:25 E WASHINGTON ST STE 908
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1718
Mailing Address - Country:US
Mailing Address - Phone:312-985-6855
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 908
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1718
Practice Address - Country:US
Practice Address - Phone:312-985-6855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009708261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health