Provider Demographics
NPI:1194016766
Name:WEXELBAUM, DARCY
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:WEXELBAUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 LACROSSE LN STE 116
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8520
Mailing Address - Country:US
Mailing Address - Phone:773-914-1615
Mailing Address - Fax:
Practice Address - Street 1:3380 LACROSSE LN STE 116
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8520
Practice Address - Country:US
Practice Address - Phone:773-914-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional