Provider Demographics
NPI:1194167585
Name:QUEFFELEC, JILL MIDDLE (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MIDDLE
Last Name:QUEFFELEC
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 1:2401 HARNISH DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-6846
Mailing Address - Country:US
Mailing Address - Phone:630-926-7659
Mailing Address - Fax:
Practice Address - Street 1:2401 HARNISH DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-6846
Practice Address - Country:US
Practice Address - Phone:630-926-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0082341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical