Healthcare Provider Details

I. General information

NPI: 1356649693
Provider Name (Legal Business Name): AMY SZUMNY M.S.,ED, COMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RANDALL RD
GENEVA IL
60134-4200
US

IV. Provider business mailing address

375 JAY ST
ELBURN IL
60119-8222
US

V. Phone/Fax

Practice location:
  • Phone: 630-208-4210
  • Fax:
Mailing address:
  • Phone: 630-336-1673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number057-001224
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: