Provider Demographics
NPI:1457361289
Name:VASILEVSKI, JOSEPH V (MA, LCPC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:V
Last Name:VASILEVSKI
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7907 W CORTLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3525
Mailing Address - Country:US
Mailing Address - Phone:708-257-1808
Mailing Address - Fax:
Practice Address - Street 1:10526 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5249
Practice Address - Country:US
Practice Address - Phone:708-257-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL738632000OtherMAGELLAN PROVIDER NUMBER
IL01635664OtherBCBS OF ILLINOIS