Healthcare Provider Details

I. General information

NPI: 1275459976
Provider Name (Legal Business Name): HAILEY JURASZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE STE 201A
NAPERVILLE IL
60563-4990
US

IV. Provider business mailing address

3750 N PAGE AVE
CHICAGO IL
60634-2017
US

V. Phone/Fax

Practice location:
  • Phone: 331-472-0326
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.032792
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: