Ebony Louise Jiminez Lee

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010715 Issued in IL

Practice address

3 S Prospect Ave
Park Ridge, IL 60068-4177

Phone

(773) 704-3920

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1891236774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7434 N CAMPBELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451649",
            "telephone_number": "773-704-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S PROSPECT AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684177",
            "telephone_number": "773-704-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMINEZ LEE",
        "first_name": "EBONY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Bauer MD SC
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• Eliot Jia, MD
• Jillian M. Wickery, PH.D., Psychological Services PLLC
• Kelly Ed Jirschele, DO
• JMJ Healthcare Services Corp
• Kimberly Ann Jobke, MS, LPC, NCC
• Dewey Joern, DPT
• John F. Davis, DDS LTD.

• Professional Counselor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.