Organization
JEFF D. KAZMIERCZAK, PSY.D., P.C.
Active
Organization
JEFF D. KAZMIERCZAK, PSY.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DAVID KAZMIERCZAK PSY.D. (PSYCHOLOGIST)
(773) 412-2778
Entity
Organization
Contact information
Practice address
19 HERITAGE DR, SUITE 211, BOURBONNAIS, IL 60914-1369
(815) 933-8760
(815) 933-9061
Mailing address
2626 FLOSSMOOR RD, 2E, FLOSSMOOR, IL 60422-1555
(773) 412-2778
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
071008293
IL
Other
Enumeration date
04/09/2012
Last updated
11/15/2012
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