Provider Demographics
NPI:1922556943
Name:KRZYKALA, KATHRYN (LCSW CAMS-II)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KRZYKALA
Suffix:
Gender:F
Credentials:LCSW CAMS-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 NORTH WESTMORELAND ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-4414
Mailing Address - Country:US
Mailing Address - Phone:312-833-1004
Mailing Address - Fax:
Practice Address - Street 1:700 NORTH WESTMORELAND ROAD
Practice Address - Street 2:A
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-4414
Practice Address - Country:US
Practice Address - Phone:312-833-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490186251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical