Individual
MRS. AUDRA K EISIN-BANAZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C
Contact information
Practice address
1309 W COLUMBIA AVE, CHICAGO, IL 60626-4325
(773) 720-2911
Mailing address
1309 W COLUMBIA AVE, CHICAGO, IL 60626-4325
(847) 217-8911
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.008801
IL
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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