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Contact Information

JESSICA MEDINA, LCSW
9119 S EXCHANGE AVE
CHICAGO, IL60617
 Phone: 773-768-5000
 Fax: 773-978-8367
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for JESSICA MEDINA · (Female)

NPI # 1316318082
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 10/07/2015
Last updated 08/16/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 149016930
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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