Healthcare Provider Details

I. General information

NPI: 1629996491
Provider Name (Legal Business Name): ROBERT RIES KRISSINGER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 ROHLWING RD
ELK GROVE VILLAGE IL
60007-3217
US

IV. Provider business mailing address

380 E ABERDEEN CT
ELMHURST IL
60126-4620
US

V. Phone/Fax

Practice location:
  • Phone: 847-524-8800
  • Fax: 847-524-8824
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.023289
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: