Jaclyn Wesolowski, MA, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180008582 Issued in IL

Practice address

25224 W Eames St
Channahon, IL 60410-5215

Phone

(815) 467-8181

NPI assigned

Mar 21, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alliance Counseling & Coaching of Illinois, LLC

  • Professional Counselor
  • Channahon, IL
  • NPI 1063867257
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1235471806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25224 W EAMES ST",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604105215",
            "telephone_number": "815-922-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25224 W EAMES ST",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604105215",
            "telephone_number": "815-467-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESOLOWSKI",
        "first_name": "JACLYN",
        "name_prefix": "Mrs.",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Victoria Walsh, MHS, CCC-SLP/L
• Robin L Watkins, PH.D.
• Deanna Carol Watson, LCSW
• Andrea L. White, ATC
• Beverly Renee Woods, RN
• Michelle Yost, NP-C
• Tanya Zima
• Haleigh Zorn, LSW

• Professional Counselor in Channahon, IL
• Providers in Channahon, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.