Most Relevant Information
Provider Data
| NPI Number: | 1003321613 |
| Provider Name: | JESSICA REID JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/05/2017 |
| Last Updated: | 12/05/2017 |
Provider Practice Location
53 W JACKSON BLVD STE 804
CHICAGO
IL
606043493
Practice Location Phone/Fax
| Phone: | 7738601001 |
| Fax: | 7738601001 |
Provider Mailing Location
1337 W WOLFRAM ST
CHICAGO
IL
606574114
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |