Provider Demographics
NPI:1487789632
Name:HAMILTON, JENNIFER JULIA (LCSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JULIA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2625
Mailing Address - Country:US
Mailing Address - Phone:630-350-2495
Mailing Address - Fax:
Practice Address - Street 1:10001 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2563
Practice Address - Country:US
Practice Address - Phone:847-455-5688
Practice Address - Fax:847-455-0744
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL23314101YA0400X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL999010Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER