Most Relevant Information
Provider Data
| NPI Number: | 1003218199 |
| Provider Name: | JACQUELINE PEARSON SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/19/2014 |
| Last Updated: | 09/19/2014 |
Provider Practice Location
18640 W. BELVIDERE ROAD
GRAYSLAKE
IL
60030
Practice Location Phone/Fax
| Phone: | 8475486000 |
| Fax: | 8475873100 |
Provider Mailing Location
2640 NISH RD
CRYSTAL LAKE
IL
600121509
Provider Mailing Phone/Fax
| Phone: | 8155576563 |
| Fax: |