Most Relevant Information
Provider Data
| NPI Number: | 1003203795 |
| Provider Name: | JESSICA CAROL NUSBAUM |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/20/2015 |
| Last Updated: | 04/20/2015 |
Provider Practice Location
101 S JEFFERSON ST
WOODSTOCK
IL
600983437
Practice Location Phone/Fax
| Phone: | 8153387360 |
| Fax: | 8153375510 |
Provider Mailing Location
101 S JEFFERSON ST
WOODSTOCK
IL
600983437
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |