Search › Illinois › 1041C0700X
Jesse Owens, M.A, LCSW
NPI 1871586214 · on the registry since 2005 · sole proprietor
Practice
- Address
- 15475 S Park Ave Ste 102
South Holland, IL 60473 - Phone
- (312) 480-5775
- Fax
- (312) 436-5208
- Organisation at this address
- B.O.O.C. Inc.
Sams Transit Llc
Sherrie C. Godbolt Md Sc
Sacred Healthcare Group Inc
Peter M. Jurkash, D.D.S.,P.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041S0200X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-10-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois