Jennifer Erin Gregg, LCSW
Individual provider Active NPI Clinical Social Worker · Glencoe, IL
NPI 1881234979 · NPPES record last updated Jan 7, 2020
Key facts
- NPI
- 1881234979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149010643 (IL)
- Practice address
- 630 Vernon Ave
Glencoe, IL 60022-1681 - Phone
- (847) 835-1770
- NPI assigned
- Jan 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149010643 | IL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149010643 | IL | Yes |
Addresses
Primary practice location
630 Vernon Ave
Glencoe, IL 60022-1681
Mailing address
1315 Lincoln St
Evanston, IL 60201-2334
Phone (773) 370-8948
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G62042576829 | Other | IL | BLUE CROSS BLUE SHIELD |
Other providers in Glencoe, IL
- Friberg Medical Associates
- Jennifer Friedman
- Gabriela Garcia
- Andrew Jonah Gomberg
- Green Balance LLC
- Nina Gelfand Harris
- Shari Friedman Hartman
- Jessica Holzman
- Susan Hudkins
- Illinois Sleep Counseling PLLC
All providers in Glencoe, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.