Healthcare Provider Details

I. General information

NPI: 1881657856
Provider Name (Legal Business Name): EVA HUZIOR LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 N HARLEM AVE SUITE 203
CHICAGO IL
60656-1803
US

IV. Provider business mailing address

720 W GORDON TER APT. 6 K
CHICAGO IL
60613-2269
US

V. Phone/Fax

Practice location:
  • Phone: 773-467-9772
  • Fax:
Mailing address:
  • Phone: 773-549-4648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: