Provider Demographics
NPI:1922332667
Name:ROGERS, JENNIFER BENDLER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:BENDLER
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:TERESE
Other - Last Name:BENDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1100 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2115
Mailing Address - Country:US
Mailing Address - Phone:847-864-3236
Mailing Address - Fax:
Practice Address - Street 1:18300 S. LAVERGNE AVE.
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477
Practice Address - Country:US
Practice Address - Phone:708-798-2272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0075321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical