Provider Demographics
NPI:1831410208
Name:KNOX, JENNIFER NATALIE (MA, LCPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NATALIE
Last Name:KNOX
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
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Mailing Address - Street 1:320 CHATELAINE CT
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-1901
Mailing Address - Country:US
Mailing Address - Phone:630-370-5546
Mailing Address - Fax:
Practice Address - Street 1:1000 JORIE BLVD STE 36
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4501
Practice Address - Country:US
Practice Address - Phone:630-370-5546
Practice Address - Fax:630-487-5626
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL364354899OtherLEYDEN DUPAGE COUNSELING SERVICE