Provider Demographics
NPI:1801165923
Name:KRAWCZYK, JESSICA LAUREN (MA)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LAUREN
Last Name:KRAWCZYK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 S QUENTIN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-6778
Mailing Address - Country:US
Mailing Address - Phone:847-359-7490
Mailing Address - Fax:847-359-7525
Practice Address - Street 1:721 S QUENTIN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6778
Practice Address - Country:US
Practice Address - Phone:847-359-7490
Practice Address - Fax:847-359-7525
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist