Provider Demographics
NPI:1861796245
Name:HUTCHINSON, JUANITA (EDD)
Entity type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:JUANITA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:61 WEST 15TH STREET
Mailing Address - Street 2:# 509
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605
Mailing Address - Country:US
Mailing Address - Phone:321-567-1290
Mailing Address - Fax:
Practice Address - Street 1:61 WEST 15TH STREET
Practice Address - Street 2:# 509
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605
Practice Address - Country:US
Practice Address - Phone:321-567-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool