Provider Demographics
NPI:1912230020
Name:JAROSIK, NANCY L
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:JAROSIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-2416
Mailing Address - Country:US
Mailing Address - Phone:815-723-0173
Mailing Address - Fax:
Practice Address - Street 1:1916 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-2416
Practice Address - Country:US
Practice Address - Phone:815-723-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator