Provider Demographics
NPI:1568858496
Name:KOZY, KARYN BRASKY (PHD)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:BRASKY
Last Name:KOZY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 BOND ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2388
Mailing Address - Country:US
Mailing Address - Phone:630-355-9002
Mailing Address - Fax:630-355-9012
Practice Address - Street 1:1415 BOND ST
Practice Address - Street 2:SUITE 127
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2388
Practice Address - Country:US
Practice Address - Phone:630-355-9002
Practice Address - Fax:630-355-9012
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009050103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical