1285850826 NPI number — JENNIFER KRISTEN TOPLIFF LCSW

Table of content: JENNIFER KRISTEN TOPLIFF LCSW (NPI 1285850826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285850826 NPI number — JENNIFER KRISTEN TOPLIFF LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOPLIFF
Provider First Name:
JENNIFER
Provider Middle Name:
KRISTEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285850826
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4537 N ARTESIAN AVE
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60625-3003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-721-7023
Provider Business Mailing Address Fax Number:
773-784-6084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4537 N ARTESIAN AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60625-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-721-7023
Provider Business Practice Location Address Fax Number:
773-784-6084
Provider Enumeration Date:
04/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)