Most Relevant Information
Provider Data
| NPI Number: | 1003300369 |
| Provider Name: | JUANITA JENKINS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2018 |
| Last Updated: | 06/20/2018 |
Provider Practice Location
19530 KEDZIE AVE
FLOSSMOOR
IL
604221778
Practice Location Phone/Fax
| Phone: | 7087992200 |
| Fax: |
Provider Mailing Location
17746 OAK PARK AVE
TINLEY PARK
IL
604773936
Provider Mailing Phone/Fax
| Phone: | 7084441012 |
| Fax: |