Provider Demographics
NPI:1255188371
Name:BRZECZEK, HANNAH A
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:A
Last Name:BRZECZEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 AZALEA DR APT 202
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1103
Mailing Address - Country:US
Mailing Address - Phone:630-666-8491
Mailing Address - Fax:
Practice Address - Street 1:1755 PARK ST STE 100
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8477
Practice Address - Country:US
Practice Address - Phone:877-486-4140
Practice Address - Fax:847-486-4145
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician