| Amy M. Jakubiak, Lcsw, Llc | |
|
72 S La Grange Rd Ste 12 La Grange IL 60525-6317 | |
| (773) 507-3631 | |
| Not Available |
| Full Name | Amy M. Jakubiak, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 72 S La Grange Rd Ste 12, La Grange, Illinois |
| Authorized Official Name and Position | Amy Marie Jakubiak (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7735073631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy M. Jakubiak, Lcsw, Llc 72 S La Grange Rd Ste 12 La Grange IL 60525-6317 Ph: (773) 507-3631 | Amy M. Jakubiak, Lcsw, Llc 72 S La Grange Rd Ste 12 La Grange IL 60525-6317 Ph: (773) 507-3631 |
| NPI Number | 1619641560 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 08/20/2021 |
| Certification Date | 08/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619641560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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