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NPI Code Detail

MEDICARE: JOHN MARTIN JAZDZEWSKI LMSW

MEDICARE: JOHN MARTIN JAZDZEWSKI LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker150015145IL

General Provider Information

NPI Number : 1174410914
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MARTIN JAZDZEWSKI LMSW
Provider Business Mailing Address
First Line : 41W400 SILVER GLEN RD
Second Line :
City : ST CHARLES
State : IL
Zip : 60175-8453
Country : US
Telephone Number : 331-901-4225
Fax Number :
Provider Business Practice Location Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-728-1744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2025
Last Update Date : 02/06/2026

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