Provider Demographics
NPI:1003277120
Name:KRANZ, ANNELIESE MICHELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:ANNELIESE
Middle Name:MICHELLE
Last Name:KRANZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 N LINCOLN PARK W
Mailing Address - Street 2:APT 509
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4708
Mailing Address - Country:US
Mailing Address - Phone:717-385-9214
Mailing Address - Fax:
Practice Address - Street 1:1200 N ASHLAND AVE
Practice Address - Street 2:SUITES 401 A-C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2259
Practice Address - Country:US
Practice Address - Phone:773-850-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health