Individual
PHILIP JAMES KOCISKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3140 W. ROUTE 64, SAINT CHARLES, IL 60175
(630) 587-5631
Mailing address
3140 W. ROUTE 64, SAINT CHARLES, IL 60175
(630) 587-5631
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178005868
IL
Other
Enumeration date
01/13/2010
Last updated
01/13/2010
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