MEDICARE: MS. BRIANA JAKUBIK

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	101YP2500X	Professional Counselor	178010697	IL

General Provider Information

NPI Number	:	1841620986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRIANA JAKUBIK

Provider Business Mailing Address
First Line	:	2452 LAUREL LN
Second Line	:
City	:	SYCAMORE
State	:	IL
Zip	:	60178-2819
Country	:	US
Telephone Number	:	630-415-9595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 N MILL ST STE F
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-4872
Country	:	US
Telephone Number	:	630-536-8073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	01/26/2024

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