Individual provider · Type 1 NPI

Jacques D. Black, LSW

Professional Counselor · Chicago, IL

NPI number 1215795000 Active

Practice location

1525 E 53rd St Ste 901
Chicago, IL 60615-4572

Call (773) 234-0644 Map

Mailing address

1403 E Evergreen Dr Apt 101
Palatine, IL 60074-8712

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1215795000

Jacques D. Black, LSW's National Provider Identifier is 1215795000, issued on Mar 7, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Sep 11, 2025.