Provider Demographics
NPI:1679802953
Name:THOMPSON, JILL ELIZABETH (LCPC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 N LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2502
Mailing Address - Country:US
Mailing Address - Phone:708-902-6134
Mailing Address - Fax:
Practice Address - Street 1:166 N LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2502
Practice Address - Country:US
Practice Address - Phone:708-902-6134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012842101YM0800X
IL180012842101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health