Provider Demographics
NPI:1356551352
Name:ROUNDS, JEAN GREGG (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:GREGG
Last Name:ROUNDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 N HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5501
Mailing Address - Country:US
Mailing Address - Phone:312-440-1203
Mailing Address - Fax:312-440-9563
Practice Address - Street 1:1707 N HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5501
Practice Address - Country:US
Practice Address - Phone:312-440-1203
Practice Address - Fax:312-440-9563
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL1490084661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist