Provider Demographics
NPI:1821689449
Name:DERKIN & KULA, INC.
Entity Type:Organization
Organization Name:DERKIN & KULA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-453-9229
Mailing Address - Street 1:4203 N DAMEN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3399
Mailing Address - Country:US
Mailing Address - Phone:773-453-9229
Mailing Address - Fax:
Practice Address - Street 1:4203 N DAMEN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3399
Practice Address - Country:US
Practice Address - Phone:773-453-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty