Provider Demographics
NPI:1821699166
Name:JENNIFER KNUEPFER, PSYD, PLLC
Entity Type:Organization
Organization Name:JENNIFER KNUEPFER, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNUEPFER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-747-8611
Mailing Address - Street 1:4256 N RAVENSWOOD AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4256 N RAVENSWOOD AVE STE 305
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1114
Practice Address - Country:US
Practice Address - Phone:630-747-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty