Provider Demographics
NPI:1932648136
Name:INTEGRATIONS, INC
Entity Type:Organization
Organization Name:INTEGRATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:WILLET
Authorized Official - Last Name:KRUCHKO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-778-1055
Mailing Address - Street 1:5912 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE HIGHLANDS
Mailing Address - State:IL
Mailing Address - Zip Code:60525-7408
Mailing Address - Country:US
Mailing Address - Phone:630-778-1055
Mailing Address - Fax:
Practice Address - Street 1:24W788 75TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-1684
Practice Address - Country:US
Practice Address - Phone:630-778-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005578103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty