Provider Demographics
NPI:1164439485
Name:RZEPCZYNSKI, BRIAN LEO (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LEO
Last Name:RZEPCZYNSKI
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 WESTBROOK DR
Mailing Address - Street 2:STE. 225
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8125
Mailing Address - Country:US
Mailing Address - Phone:630-375-7416
Mailing Address - Fax:630-499-1082
Practice Address - Street 1:4255 WESTBROOK DR
Practice Address - Street 2:STE. 225
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8125
Practice Address - Country:US
Practice Address - Phone:630-375-7416
Practice Address - Fax:630-499-1082
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0062191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL320030101OtherTAX IDENTIFICATION NUMBER