Most Relevant Information
Provider Data
| NPI Number: | 1003416124 |
| Provider Name: | JESSICA ROSE GENTRY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/28/2020 |
| Last Updated: | 10/28/2020 |
Provider Practice Location
111 N WABASH AVE STE 1400
CHICAGO
IL
606023074
Practice Location Phone/Fax
| Phone: | 3124361657 |
| Fax: | 3122844505 |
Provider Mailing Location
111 N WABASH AVE STE 1400
CHICAGO
IL
606023074
Provider Mailing Phone/Fax
| Phone: | 3124361657 |
| Fax: | 3122844505 |