Provider Demographics
NPI:1942416193
Name:KRASNOPOLSKY, DORIS PEACE (LCPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:PEACE
Last Name:KRASNOPOLSKY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617614
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-7614
Mailing Address - Country:US
Mailing Address - Phone:312-577-7630
Mailing Address - Fax:312-233-0063
Practice Address - Street 1:200 E RANDOLPH ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-6436
Practice Address - Country:US
Practice Address - Phone:312-577-7630
Practice Address - Fax:312-233-0063
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004407101YP2500X
IL180006048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional