Healthcare Provider Details

I. General information

NPI: 1770413288
Provider Name (Legal Business Name): KATARZYNA JULIA KWASNIK-MENDOZA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 EXECUTIVE PL STE 501
GENEVA IL
60134-2482
US

IV. Provider business mailing address

1250 EXECUTIVE PL STE 501
GENEVA IL
60134-2482
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-7457
  • Fax: 630-232-7567
Mailing address:
  • Phone: 630-232-7457
  • Fax: 630-232-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.012241
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: