Jingru Tan | Chicago, IL • PECOS Search

Jingru Tan

Social Worker

Behavioral Health & Social Service Providers

1445 N Cleveland Ave Apt D, Chicago, IL 60610-1132

PECOS Enrollment

Based on the most recent information from CMS, provider Jingru Tan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1285200907
Provider Type
Individual
Full Name
Tan, Jingru
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
6/2/2021
Last Updated
6/2/2021

Contact Information

Practice Location

1445 N Cleveland Ave Apt D, Chicago, IL 60610-1132

Unlisted Fax

Mailing Location

1445 N Cleveland Ave Apt D, Chicago, IL 60610-1132

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149.021398 Illinois