Healthcare Provider Details
I. General information
NPI: 1437776879
Provider Name (Legal Business Name): VESNA HEALING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2020
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 W MORSE AVE APT 203
CHICAGO IL
60626-5675
US
IV. Provider business mailing address
1225 W MORSE AVE APT 203
CHICAGO IL
60626-5675
US
V. Phone/Fax
- Phone: 773-443-6137
- Fax:
- Phone: 773-443-6137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MONIKA
GUTKOWSKA
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 773-443-6137