Provider Demographics
NPI:1679786560
Name:OSOWIEC, DARLENE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:A
Last Name:OSOWIEC
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 1:2247 BLACKBERRY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1076
Mailing Address - Country:US
Mailing Address - Phone:630-845-8740
Mailing Address - Fax:630-845-8760
Practice Address - Street 1:2247 BLACKBERRY DR
Practice Address - Street 2:SUITE A
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1076
Practice Address - Country:US
Practice Address - Phone:630-845-8740
Practice Address - Fax:630-845-8760
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005178103T00000X, 103TA0700X, 103TB0200X, 103TC2200X, 103TF0000X, 103TH0100X, 103TP2701X
CAPSY16374103T00000X, 103TA0700X, 103TB0200X, 103TC2200X, 103TF0000X, 103TH0100X, 103TP2701X
MO103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy