Individual
EMERSON LAKE KRASNICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2035 W ILES AVE STE C, SPRINGFIELD, IL 62704-7000
(224) 760-3984
Mailing address
2035 W ILES AVE STE C, SPRINGFIELD, IL 62704-7000
(224) 760-3984
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2025
Last updated
02/09/2026
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