Individual
JAMIE L WASILEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
319 E MADISON ST FL 3, SPRINGFIELD, IL 62701-1035
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1535
OR
103TC0700X
Clinical Psychologist
Primary
071.010808
IL
Other
Enumeration date
09/07/2006
Last updated
08/11/2022
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