Provider Demographics
NPI:1326182791
Name:KROFTA-THOMPSON, VICTORIA (MA)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:KROFTA-THOMPSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6523 DENALI RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-1469
Mailing Address - Country:US
Mailing Address - Phone:815-230-2940
Mailing Address - Fax:
Practice Address - Street 1:1701 QUINCY AVE
Practice Address - Street 2:SUITE 31
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3955
Practice Address - Country:US
Practice Address - Phone:630-428-1056
Practice Address - Fax:630-428-1167
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional