Provider Demographics
NPI:1487930673
Name:JAILAWI, JAMAL S (MSW)
Entity type:Individual
Prefix:MR
First Name:JAMAL
Middle Name:S
Last Name:JAILAWI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2700 PATRIOT BLVD 250
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8021
Mailing Address - Country:US
Mailing Address - Phone:312-756-0468
Mailing Address - Fax:847-324-3299
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:4210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-6031
Practice Address - Fax:312-569-6171
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490177791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical