Provider Demographics
NPI:1194113571
Name:EASTERLING-HOOD, JO
Entity type:Individual
Prefix:DR
First Name:JO
Middle Name:
Last Name:EASTERLING-HOOD
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 1:1651 E 91ST PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3502
Mailing Address - Country:US
Mailing Address - Phone:773-374-1213
Mailing Address - Fax:
Practice Address - Street 1:1651 E 91ST PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3502
Practice Address - Country:US
Practice Address - Phone:773-374-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor