Provider Demographics
NPI:1811886872
Name:KRUSINSKI, JENNIFER (LSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KRUSINSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JENN
Other - Middle Name:
Other - Last Name:KRUSINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:4021 N CLARENDON AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6318
Mailing Address - Country:US
Mailing Address - Phone:630-973-8135
Mailing Address - Fax:
Practice Address - Street 1:225 E DEERPATH STE 280
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1973
Practice Address - Country:US
Practice Address - Phone:847-796-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.117039104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker