Provider Demographics
NPI:1376296350
Name:KUCHERINA, MARAT
Entity Type:Individual
Prefix:
First Name:MARAT
Middle Name:
Last Name:KUCHERINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 W BELMONT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2166
Mailing Address - Country:US
Mailing Address - Phone:312-508-3645
Mailing Address - Fax:312-971-8554
Practice Address - Street 1:1438 W BELMONT AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2166
Practice Address - Country:US
Practice Address - Phone:312-508-3645
Practice Address - Fax:312-971-8554
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor