Provider Demographics
NPI:1245818699
Name:JAROSZ, DAVID
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:JAROSZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 PLAINFIELD RD STE H
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7626
Mailing Address - Country:US
Mailing Address - Phone:630-647-5298
Mailing Address - Fax:
Practice Address - Street 1:535 PLAINFIELD RD STE H
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7626
Practice Address - Country:US
Practice Address - Phone:630-647-5298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014211101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health