Healthcare Provider Details

I. General information

NPI: 1376399048
Provider Name (Legal Business Name): JANET JAKOVA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 LINCOLN AVE
LISLE IL
60532-2117
US

IV. Provider business mailing address

777 W ARMY TRAIL BLVD FL 2
ADDISON IL
60101-3163
US

V. Phone/Fax

Practice location:
  • Phone: 630-271-4229
  • Fax:
Mailing address:
  • Phone: 630-693-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.022677
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: