Provider Demographics
NPI:1942989124
Name:SIMMONS, JANNETTE E
Entity type:Individual
Prefix:MRS
First Name:JANNETTE
Middle Name:E
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-2155
Mailing Address - Country:US
Mailing Address - Phone:402-750-0279
Mailing Address - Fax:
Practice Address - Street 1:1595 WELD RD STE 9
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-0000
Practice Address - Country:US
Practice Address - Phone:847-707-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist