Provider Demographics
NPI:1720394356
Name:SINGER, JODIE ERIN (MA, PSYD)
Entity Type:Individual
Prefix:DR
First Name:JODIE
Middle Name:ERIN
Last Name:SINGER
Suffix:
Gender:F
Credentials:MA, PSYD
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:ERIN
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, PSYD
Mailing Address - Street 1:5246 W CARMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2211
Mailing Address - Country:US
Mailing Address - Phone:312-566-8536
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1717
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1839
Practice Address - Country:US
Practice Address - Phone:312-566-8536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1720394356OtherPERSONAL NPI