Provider Demographics
NPI:1265124911
Name:PRITSCHER, DANIEL
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:PRITSCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 N RIDGE AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3255
Mailing Address - Country:US
Mailing Address - Phone:312-330-7711
Mailing Address - Fax:
Practice Address - Street 1:5920 N RIDGE AVE APT 216
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3255
Practice Address - Country:US
Practice Address - Phone:312-330-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health