Provider Demographics
NPI:1710998679
Name:EBEID, JENNY T (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:T
Last Name:EBEID
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:TADROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9010 RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1183
Mailing Address - Country:US
Mailing Address - Phone:630-745-0080
Mailing Address - Fax:815-293-0817
Practice Address - Street 1:1426 FERNCROFT CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9772
Practice Address - Country:US
Practice Address - Phone:630-745-0080
Practice Address - Fax:815-293-0817
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007039103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical