Healthcare Provider Details

I. General information

NPI: 1144156555
Provider Name (Legal Business Name): JENNIFER OSWALD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24012 W RENWICK RD STE 204
PLAINFIELD IL
60544-8733
US

IV. Provider business mailing address

24012 W RENWICK RD STE 204
PLAINFIELD IL
60544-8733
US

V. Phone/Fax

Practice location:
  • Phone: 630-723-9466
  • Fax:
Mailing address:
  • Phone: 630-723-9466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180018072
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: