Healthcare Provider Details

I. General information

NPI: 1417852419
Provider Name (Legal Business Name): KAMILA SMYK PSYCHOTHERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S PROSPECT AVE # 315
PARK RIDGE IL
60068-4037
US

IV. Provider business mailing address

1928 N SAYRE AVE
CHICAGO IL
60707-3838
US

V. Phone/Fax

Practice location:
  • Phone: 708-856-7343
  • Fax:
Mailing address:
  • Phone: 708-856-7343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAMILA SMYK-JAWORSKI
Title or Position: OWNER
Credential: PSY.D.
Phone: 708-856-7343