Healthcare Provider Details

I. General information

NPI: 1598085821
Provider Name (Legal Business Name): JACQUELINE C SCHIESZLER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SPALDING DR STE 408 MEDICAL OFFICE BUILDING II
NAPERVILLE IL
60540-6558
US

IV. Provider business mailing address

120 SPALDING DR STE 408 MEDICAL OFFICE BUILDING II
NAPERVILLE IL
60540-6558
US

V. Phone/Fax

Practice location:
  • Phone: 630-334-9435
  • Fax: 630-848-1208
Mailing address:
  • Phone: 630-334-9435
  • Fax: 630-848-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number149.007461
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: