Provider Demographics
NPI:1336295757
Name:JOURNEY WORKS, LTD.
Entity Type:Organization
Organization Name:JOURNEY WORKS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-604-0734
Mailing Address - Street 1:1217 MCHENRY RD
Mailing Address - Street 2:233
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1379
Mailing Address - Country:US
Mailing Address - Phone:847-604-0734
Mailing Address - Fax:847-793-8830
Practice Address - Street 1:1217 MCHENRY RD
Practice Address - Street 2:233
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1379
Practice Address - Country:US
Practice Address - Phone:847-604-0734
Practice Address - Fax:847-793-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty