Provider Demographics
NPI:1649492315
Name:DUFF, JENNIFER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:DUFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 E OGDEN AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8609
Mailing Address - Country:US
Mailing Address - Phone:630-420-9707
Mailing Address - Fax:630-420-9708
Practice Address - Street 1:1020 E OGDEN AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8609
Practice Address - Country:US
Practice Address - Phone:630-420-9707
Practice Address - Fax:630-420-9708
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical