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General NPI Number Information
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NPI Number | 1174410914
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Entity Type | Individual
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Provider Name | JOHN MARTIN JAZDZEWSKI LMSW
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Gender | Male
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 414 PLAZA DR STE 301
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City | WESTMONT
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State | IL
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Zip | 60559-5508
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Country | US
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Telephone | 630-728-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 41W400 SILVER GLEN RD
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City | ST CHARLES
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State | IL
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Zip | 60175-8453
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Country | US
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Telephone | 331-901-4225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150015145
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License Number State | IL
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