Provider Demographics
NPI:1124331954
Name:NIKKILA, JESSICA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:NIKKILA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-0492
Mailing Address - Country:US
Mailing Address - Phone:773-343-4204
Mailing Address - Fax:
Practice Address - Street 1:3533 MORTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513-1112
Practice Address - Country:US
Practice Address - Phone:773-343-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490124281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical