Provider Demographics
NPI:1154515179
Name:BIALEK, JENNIFER D (LCPC, CADC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:D
Last Name:BIALEK
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 CESARIO CIR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-2700
Mailing Address - Country:US
Mailing Address - Phone:630-871-1484
Mailing Address - Fax:630-871-0741
Practice Address - Street 1:2110 CESARIO CIR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-2700
Practice Address - Country:US
Practice Address - Phone:630-871-1484
Practice Address - Fax:630-871-0741
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL20375101YA0400X
IL180.006482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)