DR. JENNY H CONVISER


Address: 737 N Michigan Ave, Suite 1625, Chicago, IL 60611-2615
Phone: 3124096800

DR. JENNY H CONVISER (NPI# 1720293392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720293392
Entity Type Individual
Full Name DR. JENNY H CONVISER
Credential PSY.D.
Practice Address 737 N Michigan Ave
Suite 1625
Chicago
IL 60611-2615
Practice Telephone 3124096800
Mailing Telephone 3124096800
Enumeration Date 2007-05-14
Last Update Date 2013-03-21
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
071.004492 IL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL BCBS PROVIDER NUMBER 1607378 01
IL STATE LICENSE NO 071.004492 01

Office Location

Street Address 737 N MICHIGAN AVE
SUITE 1625
City CHICAGO
State IL
Zip Code 60611-2615

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1336599778 Taylor Pruett Social Worker 737 N Michigan Ave, Suite 1925, Chicago, IL 60611-2615 2016-06-16
1831547595 Michael Robert Milco Social Worker 737 N Michigan Ave, Suite 1925, Chicago, IL 60611-2615 2016-06-02
1780032870 Stephanie Christine Stuhlmuller Nurse Practitioner 737 N Michigan Ave, Suite 2020, Chicago, IL 60611-2615 2016-05-30
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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1881293108 Haley Michelle Sims Psychologist 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 2020-10-19
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1053920512 Alyse Renae Bedell Psychologist 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 2020-07-30
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Competitor

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City CHICAGO
Zip Code 60611

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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