Provider Demographics
NPI:1801293857
Name:BILSTROM, JODYNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JODYNE
Middle Name:
Last Name:BILSTROM
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5664 E SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83406-8369
Mailing Address - Country:US
Mailing Address - Phone:630-234-7295
Mailing Address - Fax:208-785-3115
Practice Address - Street 1:201 E OGDEN AVE
Practice Address - Street 2:#115
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3633
Practice Address - Country:US
Practice Address - Phone:630-325-2880
Practice Address - Fax:630-325-2890
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490170981041C0700X
ID350281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical