Provider Demographics
NPI:1235292988
Name:DUCATO, HEATHER HELEN (MS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:HELEN
Last Name:DUCATO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 BEAUMONT CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-6988
Mailing Address - Country:US
Mailing Address - Phone:630-631-4332
Mailing Address - Fax:
Practice Address - Street 1:1324 E OGDEN AVE STE 106
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2347
Practice Address - Country:US
Practice Address - Phone:630-631-4332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002232774OtherBSBC IL PROVIDER #