Provider Demographics
NPI:1366735250
Name:BECKMAN, JENNIFER (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:S
Other - Last Name:WILKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1000 REMINGTON BOULEVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440
Mailing Address - Country:US
Mailing Address - Phone:630-914-2417
Mailing Address - Fax:630-914-2469
Practice Address - Street 1:1000 REMINGTON 16151 WEBER ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CRESTHILL
Practice Address - State:IL
Practice Address - Zip Code:60403
Practice Address - Country:US
Practice Address - Phone:815-773-7827
Practice Address - Fax:630-914-2469
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490141641041C0700X
IL149.0141641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical