Healthcare Provider Details

I. General information

NPI: 1215224571
Provider Name (Legal Business Name): JENNIFER NICOLE BUDRUWEIT BA, MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER CHIANELLI BA, MA

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N PLAZA DR STE 101
SCHAUMBURG IL
60173-4916
US

IV. Provider business mailing address

1111 N PLAZA DR STE 101
SCHAUMBURG IL
60173-4916
US

V. Phone/Fax

Practice location:
  • Phone: 847-212-6466
  • Fax: 888-234-7628
Mailing address:
  • Phone: 888-234-7628
  • Fax: 888-234-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180008946
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: