Provider Demographics
NPI:1295423184
Name:KRUPA, MICHELLE HELEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:HELEN
Last Name:KRUPA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:HELEN
Other - Last Name:OKOLITA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:1100 W LAKE COOK RD # 210
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-2083
Mailing Address - Country:US
Mailing Address - Phone:847-979-0268
Mailing Address - Fax:
Practice Address - Street 1:1100 W LAKE COOK RD # 210
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-2083
Practice Address - Country:US
Practice Address - Phone:847-979-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist