Individual
DEA KENTCHADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
800 S MCHENRY AVE STE F, CRYSTAL LAKE, IL 60014-7487
(815) 526-3750
Mailing address
800 S MCHENRY AVE STE F, CRYSTAL LAKE, IL 60014-7487
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.021855
IL
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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