Provider Demographics
NPI:1326915406
Name:WILLOW PSYCHOLOGY GROUP
Entity type:Organization
Organization Name:WILLOW PSYCHOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKOVLJEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-613-0377
Mailing Address - Street 1:540 W FRONTAGE RD STE 2320
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:540 W FRONTAGE RD STE 2320
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1226
Practice Address - Country:US
Practice Address - Phone:708-613-0377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty