IndividualActive
Persell Jefferson
NPI 1992580666 · Clinical Psychologist · Chicago, IL
Persell Jefferson is a Clinical Psychologist provider in Chicago, IL (NPI 1992580666).
Provider details
- NPI number
- 1992580666
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1110-1110 (IL)
Practice location
11337 S Wallace St
Chicago, IL 60628-4729
Phone: (773) 698-3088
Street-level locationGet directions
Mailing address
11337 S Wallace St
Chicago, IL 60628-4729
Registry dates
- Enumerated
- 2023-08-30
- Last updated
- 2023-08-30
- Certified
- 2021-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.