| Jennie N. Marquez | |
|
4777 E State St Suite 1 Rockford IL 61108-2273 | |
| (815) 977-1425 | |
| Not Available |
| Full Name | Jennie N. Marquez |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4777 E State St, Rockford, Illinois |
| Authorized Official Name and Position | Jennie N. Marquez (CEO) |
| Authorized Official Contact | 8159771425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennie N. Marquez 416 E Lincoln Ave Belvidere IL 61008-2839 Ph: (815) 977-1425 | Jennie N. Marquez 4777 E State St Suite 1 Rockford IL 61108-2273 Ph: (815) 977-1425 |
| NPI Number | 1023449972 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 12/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023449972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180-006644 (Illinois) | Primary |
| 1041C0700X | Social Worker - Clinical | 149.008535 (Illinois) | Secondary |
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