| Doctor Name: | MRS. JACLYN WESOLOWSKI |
| NPI Number: | 1235471806 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LCPC |
| License Number: | 180008582 |
| Business Practice Address: | 25224 W Eames St Channahon, IL - 604105215 |
| Business Phone Number: | 8154678181 |
| Business Fax Number: | |
| Mailing Address: | 25224 W Eames St, CHANNAHON |
| State: | IL |
| Postal Code: | 604105215 |
| Phone Number: | 8159229561 |
| Fax Number: | |
| NPI Enumeration Date: | 03/21/2013 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180008582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |