Provider Demographics
NPI:1891355830
Name:PETROSCHUK, EMILY (MA, LPC, NCC)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:
Last Name:PETROSCHUK
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 N SHERIDAN RD
Mailing Address - Street 2:#708
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:773-906-3225
Mailing Address - Fax:773-906-3270
Practice Address - Street 1:8324 SKOKIE BLVD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2545
Practice Address - Country:US
Practice Address - Phone:837-933-0051
Practice Address - Fax:847-933-0057
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health