Individual
ELLEN HENDRICKSON KURCZAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 W ROOSEVELT RD, CHICAGO, IL 60608-1131
(312) 618-8647
Mailing address
5421 N LIEB AVE, CHICAGO, IL 60630-1407
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2021
Last updated
07/13/2021
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