Healthcare Provider Details

I. General information

NPI: 1326386657
Provider Name (Legal Business Name): ASHLEY JEAN NORKUS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY JEAN DZIELAWA LPC

II. Dates (important events)

Enumeration Date: 01/21/2013
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 DRESDEN DR
MORRIS IL
60450-2476
US

IV. Provider business mailing address

120 SPALDING DR SUITE 408 MEDICAL OFFICE BULIDING 2
NAPERVILLE IL
60540-6508
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-5200
  • Fax:
Mailing address:
  • Phone: 630-848-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180011735
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: