Provider Demographics
NPI:1790749620
Name:FROEMEL, JENNIFER C (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:C
Last Name:FROEMEL
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3640 PRAIRIE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-3015
Mailing Address - Country:US
Mailing Address - Phone:312-343-7400
Mailing Address - Fax:708-294-3699
Practice Address - Street 1:715 LAKE ST STE 800
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1417
Practice Address - Country:US
Practice Address - Phone:312-343-7400
Practice Address - Fax:708-294-3699
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634705OtherBCBS PPO
IL248001003Medicaid
IL1617631OtherBLUE CROSS BLUE SHIELD
IL202591OtherMEDICARE