| Doctor Name: | JENNIFER MARIE FONTANA |
| NPI Number: | 1013378041 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC, LMSW |
| License Number: | 31246 |
| Business Practice Address: | 5635 W Roosevelt Rd Cicero, IL - 608041230 |
| Business Phone Number: | 7086526500 |
| Business Fax Number: | |
| Mailing Address: | 5635 W Roosevelt Rd, CICERO |
| State: | IL |
| Postal Code: | 608041230 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2016 |
| NPI Last Update Date: | 05/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 31246 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |