Provider Demographics
NPI:1164445557
Name:VILLAGE OF OAK LAWN FAMILY SERVICE
Entity Type:Organization
Organization Name:VILLAGE OF OAK LAWN FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY SERVICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WESOLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:AM, LCSW
Authorized Official - Phone:708-423-3361
Mailing Address - Street 1:9401 S 53RD CT
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2426
Mailing Address - Country:US
Mailing Address - Phone:708-423-3361
Mailing Address - Fax:708-499-7093
Practice Address - Street 1:9401 S 53RD CT
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2426
Practice Address - Country:US
Practice Address - Phone:708-423-3361
Practice Address - Fax:708-499-7093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty